Sodium–Glucose Cotransporter 2 Inhibitor Treatment and Risk of Atrial Fibrillation: Scandinavian Cohort Study
Authors' conclusion
In this cohort study using nationwide data from three countries, use of SGLT2 inhibitors, compared with GLP-1 receptor agonists, was associated with a modestly reduced risk of new-onset AF.
Study context
- Population
- Patients without a history of atrial fibrillation (AF) newly prescribed an SGLT2i or a GLP-1 RA, nationwide registers in Denmark, Norway and Sweden, 2013–2018; mean age 61 years, 60% men
- Participants
- 79,343 vs 57,613
- Exposure
- SGLT2 inhibitors vs GLP-1 RA
- SGLT2 inhibitorsn = 79,343
- GLP-1 receptor agonistsn = 57,613reference
- Outcome
- New-onset AF
Methodological detailsnationwide registers (Denmark, Norway, Sweden), active comparator, new-user design, propensity score weighting
- Nationwide registers (Denmark, Norway, Sweden)
- Active comparator
- New-user design
- Propensity score weighting
Main finding
As reported in the abstract
SGLT2i
8.6 per 1,000 person-years
GLP-1 RA
10.0 per 1,000 person-years
SGLT2i vs GLP-1 RAAdjusted hazard ratio (95% CI)
New-onset AF
0.89(0.81–0.96)
SGLT2i vs GLP-1 RARate difference, events per 1,000 person-years (95% CI)
Fewer with SGLT2i
1.4(0.6–2.1)
Observational data: associations, not effects.
Further findings
New-onset AF, as-treated exposure definition
- aHR for new-onset AF (as-treated)
- 0.87 (95% CI 0.76-0.99)
New-onset AF by subgroup: history of HF or major CVD
- No statistically significant heterogeneity of the aHRs between subgroups with and without a history of HF or major CVD
Original publication
Sodium–Glucose Cotransporter 2 Inhibitor Treatment and Risk of Atrial Fibrillation: Scandinavian Cohort Study. Diabetes Care. Published 12 December 2022. doi:10.
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