Sodium-glucose Co-transporter 2 Inhibitor Treatment and Risk of Atrial Fibrillation: Scandinavian Cohort Study

Sunday, August 28, 2022

8:30 AM – 8:45 AM CEST

Location: C1M1

Publication Number: 230

Background: Type 2 diabetes is a risk factor for developing atrial fibrillation (AF). Data from clinical trials suggest that sodium-glucose co-transporter 2 (SGLT2) inhibitors may reduce the risk of AF.

Objectives: To assess the association between use of SGLT2 inhibitors and the risk of new-onset AF in routine clinical practice.

Methods: We used nationwide registers in Denmark, Norway and Sweden, 2013-2018, to include patients without history of AF who were newly prescribed an SGLT2 inhibitor or an active comparator (glucagon-like peptide-1 [GLP-1] receptor agonist). We performed a cohort study to assess new-onset AF in intention-to-treat analyses using Cox regression, adjusted for covariates with propensity score weighting.

Results: We identified 79343 new users of SGLT2 inhibitors and 57613 new users of GLP-1 receptor agonists. The adjusted incidence rate of new-onset AF was 8.6 per 1000 person-years for new users of SGLT2 inhibitors as compared with 10.0 per 1000 person-years for new users of GLP-1 receptor agonists. The adjusted hazard ratio (aHR) was 0.89 (95% CI 0.81-0.96) and the rate difference was 1.4 fewer events per 1000 person-years (95% CI 0.6-2.1). Using an as-treated exposure definition, the aHR for new-onset AF was 0.87 (95% CI 0.76-0.99). No statistically significant heterogeneity of the aHRs was observed between subgroups of patients with and without a history of heart failure or major cardiovascular disease.

Conclusions: In this cohort study using nationwide data from three countries, use of SGLT2 inhibitors as compared with GLP-1 receptor agonists, was associated with a reduced risk of new-onset AF.

Presenting Author(s)

Arvid Engstr�m

Karolinska Institutet
Stockholm, Stockholms l�n, Sweden

Slides

Co-Author(s)

Victor Wintzell

Clinical Epidemiology Division, Department of Medicine, Solna, Karolinska Institutet, Stockholm
Stockholm, Sweden
MM

Mads Melbye

Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark, Denmark
AH

Anders Hviid

Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark, Denmark
BE

Björn Eliasson

Department of Molecular and Clinical Medicine, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden, Sweden
SG

Soffia Gudbjörnsdottir

Department of Molecular and Clinical Medicine, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden, Sweden
KH

Kristian Hveem

HUNT Research Center, Faculty of Medicine, NTNU—Norwegian University of Science and Technology, Levanger, Norway, Norway
CJ

Christian Jonasson

HUNT Research Center, Faculty of Medicine, NTNU—Norwegian University of Science and Technology, Levanger, Norway, Norway
HS

Henrik Svanström

Clinical Epidemiology Division, Department of Medicine, Solna, Karolinska Institutet, Stockholm, Sweden, Sweden
BP

Björn Pasternak

Division of Clinical Epidemiology, Department of Medicine Solna, Karolinska Institutet, Sweden
PU

Peter Ueda

Clinical Epidemiology Division, Department of Medicine, Solna, Karolinska Institutet, Stockholm, Sweden, Sweden