Effect of SGLT-2 inhibitors on arrhythmia events: insight from an updated secondary analysis of > 80,000 patients (the SGLT2i—Arrhythmias and Sudden Cardiac Death)
Pooled result · AFResult — go to the resultRelative risk 0.88 95% CI 0.78–1.00Authors' conclusion
SGLT2i lowers the risks of AF and AF/AFL, and this favorable effect appeared to be particularly pronounced in patients with HFrEF, male gender, dapagliflozin, and longer follow-up (> 1 year). SGLT2i lowers the risk of SCD only in heart failure patients.
Study context
- Population
- Patients in placebo-controlled randomized controlled trials (RCTs) of SGLT2i; mean age 64.9 ± 9.4 years, 63.0% male; databases searched up to April 2023
- Participants
- 88,098 patients33 RCTs
- Comparison
- SGLT2i vs placebo
- SGLT2in = 48,585
- Placebon = 39,513reference
- Outcome
- Arrhythmias: AF, atrial flutter (AFL), composite AF/AFL, ventricular fibrillation (VF), ventricular tachycardia (VT), ventricular extrasystoles, sudden cardiac death (SCD), composite VF/VT/SCD
- Follow-up
- Mean 1.4 ± 1.1 years
Methodological detailsplacebo-controlled RCTs
- Placebo-controlled RCTs
Pooled result
AF
Relative risk
0.88
95% CI 0.78–1.00
P = 0.04
SGLT2ivs Placebo
RR 0.88 (95% CI 0.78–1.00); P = 0.04
As reported in the abstract
Further pooled results
| Outcome | RR (95% CI) | P value | |
|---|---|---|---|
| Composite AF/AFL | 0.86 (0.77–0.96) | P = 0.01 | |
| 0.512Relative risk (log scale) |
| Outcome | RR | P value |
|---|---|---|
| SCD in heart failure patientsBorderline lower risk | 0.67 | P = 0.05 |
Composite atrial fibrillation (AF)/atrial flutter (AFL)
- Favorable effect substantially pronounced in HFrEF, male gender, dapagliflozin and > 1 year follow-up
Other ventricular arrhythmic outcomes
- No significant effects of SGLT2i on other ventricular arrhythmic outcomes
Original publication
Effect of SGLT-2 inhibitors on arrhythmia events: insight from an updated secondary analysis of > 80,000 patients (the SGLT2i—Arrhythmias and Sudden Cardiac Death). Cardiovasc Diabetol. Published 24 February 2024. doi:10.
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