University Hospital Gentofte and Herlev, Kildegaardsvej 28, 2900 Hellerup, Copenhagen, Denmark.
Faculty of Health and Medical Sciences Blegdamsvej 3B, 2200, Copenhagen, Denmark.
Eur Heart J Cardiovasc Pharmacother. 2017 Jul 1;3(3):140-146. doi: 10.1093/ehjcvp/pvw036.
The aim of this study was to investigate the association between thiazolidinediones (TZDs) vs. other antidiabetic drugs and risk of atrial fibrillation (AF) in diabetic patients.
Diabetes mellitus (diabetes) increases the risk of AF by approximately 34%. TZD is an insulin sensitizer that also has anti-inflammatory effects, which might decrease the risk of AF compared with other antidiabetic drugs. We used data from the Danish nationwide registries to study 108 624 patients with diabetes and without prior AF who were treated with metformin or sulfonylurea as first-line drugs. The incidence of AF was significantly lower with TZD as the second-line antidiabetic treatment compared with other second-line antidiabetic drugs (P < 0.001). The 10 year cumulative incidence [95% confidence interval (95% CI)] of AF was 6.2% (3.1-9.3%) with TZD vs. 10.2% (9.8-10.6%) with other antidiabetic drugs. The decreased risk of AF remained significant after adjusting for age, sex, and comorbidities with a hazard ratio (95% CI) of 0.76 (0.57-1.00), P = 0.047 associated with TZD treatment compared with other antidiabetic drugs.
Use of a TZD to treat diabetes was associated with reduced risk of developing AF compared with other antidiabetic drugs as second-line treatment.
本研究旨在探讨噻唑烷二酮（TZDs）与其他抗糖尿病药物相比，与糖尿病患者心房颤动（AF）风险的相关性。
糖尿病使 AF 的风险增加约 34%。TZDs 是一种胰岛素增敏剂，具有抗炎作用，与其他抗糖尿病药物相比，可能降低 AF 的风险。我们使用丹麦全国性登记处的数据，研究了 108624 名无 AF 病史且最初使用二甲双胍或磺酰脲类药物治疗的糖尿病患者。与其他二线抗糖尿病药物相比，TZDs 作为二线抗糖尿病治疗时，AF 的发病率明显较低（P<0.001）。AF 的 10 年累积发生率[95%置信区间（95%CI）]TZDs 组为 6.2%（3.1-9.3%），其他抗糖尿病药物组为 10.2%（9.8-10.6%）。调整年龄、性别和合并症后，TZDs 治疗与其他抗糖尿病药物相比，AF 的风险比（95%CI）仍显著降低，为 0.76（0.57-1.00），P=0.047。
与其他二线抗糖尿病药物相比，使用 TZDs 治疗糖尿病与降低发生 AF 的风险相关。
