Liu Xuyang, Feng Shenghui, Chen Zhuohui, Zhou Yue, Yin Kang, Xue Zhengbiao, Zhu Wengen
Department of Cardiology, Jinggangshan University, Ji'an, China.
Queen Mary School, Medical Department, Nanchang University, Nanchang, China.
Front Cardiovasc Med. 2022 May 19;9:874795. doi: 10.3389/fcvm.2022.874795. eCollection 2022.
The use of anticoagulants is an established strategy to prevent stroke, embolism, and cardiovascular mortality in patients with atrial fibrillation (AF), but its role in the prevention of incident diabetes is unclear. We aimed to investigate this question by using participant data from cohort studies.
We conducted a meta-analysis of participants to investigate the impact of direct oral anticoagulants (DOACs) on the risk of new-onset diabetes in AF patients. The collection of related data was performed in the PubMed and EMBASE databases until December 2021, including studies associated with evaluating the correlation between DOACs and incident diabetes. The hazard ratios (HRs) and 95% confidence intervals (CIs) were adjusted by the random-effects model with an inverse variance method.
Two cohort studies with a total of 24,434 patients were included in this study (warfarin: = 6,906; DOACs: = 17,528). Compared with warfarin, the use of DOACs could reduce the incident diabetic risk in AF patients (HR = 0.75, 95%CI: 0.68-0.82). Investigations about the effects of three major classes of DOACs showed that the individual use of dabigatran (HR = 0.76, 95%CI: 0.64-0.90), rivaroxaban (HR = 0.74, 95%CI: 0.64-0.87), apixaban (HR = 0.74, 95%CI: 0.60-0.92) and the combined use of rivaroxaban and apixaban (HR = 0.74, 95%CI: 0.66-0.84) could reduce the risk of new-onset diabetes compared with warfarin. This risk reduction effect could be observed in both male and female groups (HR = 0.73, 95%CI: 0.64-0.84, < 0.00001; HR = 0.82, 95%CI: 0.82-0.99, = 0.04).
Treatment with DOACs compared with warfarin reduced the risk of new-onset diabetes in both male and female patients with AF.
使用抗凝剂是预防心房颤动（AF）患者中风、栓塞和心血管死亡的既定策略，但其在预防新发糖尿病方面的作用尚不清楚。我们旨在通过使用队列研究中的参与者数据来研究这个问题。
我们对参与者进行了一项荟萃分析，以研究直接口服抗凝剂（DOACs）对AF患者新发糖尿病风险的影响。相关数据的收集在PubMed和EMBASE数据库中进行，直至2021年12月，包括与评估DOACs和新发糖尿病之间相关性的研究。风险比（HRs）和95%置信区间（CIs）采用随机效应模型和逆方差法进行调整。
本研究纳入了两项队列研究，共24434名患者（华法林组：=6906；DOACs组：=17528）。与华法林相比，使用DOACs可降低AF患者的新发糖尿病风险（HR=0.75，95%CI：0.68-0.82）。对三大类DOACs作用的研究表明，与华法林相比，单独使用达比加群（HR=0.76，95%CI：0.64-0.90）、利伐沙班（HR=0.74，95%CI：0.64-0.87）、阿哌沙班（HR=0.74，95%CI：0.60-0.92）以及利伐沙班和阿哌沙班联合使用（HR=0.74，95%CI：0.66-0.84）均可降低新发糖尿病风险。在男性和女性组中均可观察到这种风险降低效应（HR=0.73，95%CI：0.64-0.84，<0.00001；HR=0.82，95%CI：0.82-0.99，=0.04）。
与华法林相比，DOACs治疗可降低男性和女性AF患者的新发糖尿病风险。
