SGLT2 Inhibitors vs GLP-1 Receptor Agonists and Clinical Outcomes in Patients With Diabetes With/Without Atrial Fibrillation
Main finding · Hospitalization for HF, by AF statusResult — go to the resultHazard ratio 0.48 95% CI 0.36–0.66Authors' conclusion
Considering the high risk of developing HF and/or high prevalence of concomitant HF in patients with concomitant diabetes and AF, whether SGLT2is should be the preferred treatment to GLP-1RAs for such a high-risk population requires further investigation.
Study context
- Population
- Patients with T2D with/without concomitant Atrial Fibrillation (AF), Taiwan National Health Insurance Research Database, May 1, 2016 to December 31, 2019; follow-up to December 31, 2020
- Participants
- 11,462 / 816 / 344,392 / 31,351
- Exposure
- SGLT2i vs GLP-1RA in T2D with and without AF
- SGLT2i, AFn = 11,462
- GLP-1RA, AFn = 816reference
- SGLT2i, non-AFn = 344,392
- GLP-1RA, non-AFn = 31,351reference
- Outcome
- Hospitalization for heart failure (HF), by AF status
Methodological detailsnationwide, propensity score-stabilized weight
- Nationwide
- Propensity score-stabilized weight
Main finding
As reported in the abstract
Hazard ratio
0.48
95% CI 0.36–0.66
P < .01 for homogeneity
By group
SGLT2i, AF
2.32 events per 100 person-years
GLP-1RA, AF
4.74 events per 100 person-years
SGLT2i, AFvs GLP-1RA, AF
HR 0.48 (95% CI 0.36–0.66); P for homogeneity < .01
Observational data: associations, not effects.
Further findings
Events per 100 person-years
| Outcome | SGLT2i, AF | GLP-1RA, AF | SGLT2i, non-AF | GLP-1RA, non-AF | HR (95% CI) | |
|---|---|---|---|---|---|---|
| Composite kidney outcomes, AF cohortSGLT2i, AFvs GLP-1RA, AF | 0.38 | 0.79 | — not stated in the abstract | — not stated in the abstract | 0.47 (0.23–0.96) | |
| Composite kidney outcomes, non-AF cohortSGLT2i, non-AFvs GLP-1RA, non-AF | — not stated in the abstract | — not stated in the abstract | 0.09 | 0.18 | 0.53 (0.43–0.64) | |
| 0.20.5125Hazard ratio (log scale) |
— not stated in the abstract
MACE and all-cause mortality
- No significant differences with SGLT2i vs GLP-1RA in AF or non-AF cohorts
Incidence of all study outcomes by AF status
- Much higher incidence with concomitant AF than without
Original publication
SGLT2 Inhibitors vs GLP-1 Receptor Agonists and Clinical Outcomes in Patients With Diabetes With/Without Atrial Fibrillation. J Clin Endocrinol Metab. Published 11 March 2024. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →