Glucagon-like peptide-1 receptor agonists versus sodium-glucose cotransporter-2 inhibitors in adults with type 2 diabetes and atrial fibrillation: a multicenter comparative effectiveness cohort study of cardiovascular and arrhythmic outcomes
Main finding · All-cause mortalityResult — go to the resultHazard ratio 0.64 95% CI 0.57–0.71Authors' conclusion
Over 1 year, GLP-1RA initiation was associated with lower risks of mortality, hospitalization, atherosclerotic events, and adverse AF disease-course outcomes than SGLT-2i in adults with concurrent AF and T2D
Study context
- Population
- Adults with concurrent atrial fibrillation (AF) and T2D, TriNetX Research Network (2016–2024); mean age 67.4 years; 52.2% malematched cohort
- Participants
- 18,035 vs 18,035
- Exposure
- GLP-1 RA vs SGLT2i
- GLP-1RAn = 18,035
- SGLT-2in = 18,035reference
- Outcome
- All-cause mortality
- Follow-up
- 365 days
Methodological detailspropensity-score matched, multicenter, new-user, active-comparator design, 1:1 matched, Cox proportional hazards regression; Benjamini-Hochberg false discovery rate control; E-values for unmeasured confounding
- Propensity-score matched
- Multicenter
- New-user, active-comparator design
- 1:1 matched
- Cox proportional hazards regression; Benjamini-Hochberg false discovery rate control; E-values for unmeasured confounding
Main finding
As reported in the abstract
Hazard ratio
0.64
95% CI 0.57–0.71
GLP-1RAvs SGLT-2i
HR 0.64 (95% CI 0.57–0.71)
Observational data: associations, not effects.
Further findings
| Outcome | HR (95% CI) | |
|---|---|---|
| Hospitalization · 365 days | 0.88 (0.84–0.92) | |
| 3-point MACE · 365 days | 0.78 (0.71–0.86) | |
| AF progression · 365 days | 0.94 (0.90–0.98) | |
| AF ablation · 365 days | 0.81 (0.70–0.94) | |
| Cardioversion · 365 days | 0.79 (0.70–0.90) | |
| 0.512Hazard ratio (log scale) |
Age and BMI subgroups; robustness
- E-values
- 1.5 - 2.5
- Effects were consistent across age and BMI subgroups
Original publication
Glucagon-like peptide-1 receptor agonists versus sodium-glucose cotransporter-2 inhibitors in adults with type 2 diabetes and atrial fibrillation: a multicenter comparative effectiveness cohort study of cardiovascular and arrhythmic outcomes. Diabetes Res Clin Pract. Published 28 May 2026. doi:10.
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