Stachteas Panagiotis, Nasoufidou Athina, Karagiannidis Efstratios, Patoulias Dimitrios, Karakasis Paschalis, Alexiou Sophia, Samaras Athanasios, Zormpas Georgios, Stavropoulos George, Tsalikakis Dimitrios, Kassimis George, Papadopoulos Christodoulos, Fragakis Nikolaos
Second Cardiology Department, Medical School, Hippokration General Hospital, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece.
Outpatient Department of Cardiometabolic Medicine, Second Cardiology Department, Medical School, Hippokration General Hospital, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece.
J Clin Med. 2024 Sep 12;13(18):5408. doi: 10.3390/jcm13185408.
Atrial fibrillation (AF) is the most prevalent arrhythmia among adults worldwide, frequently co-occurring with comorbidities such as Heart Failure (HF) and Type 2 Diabetes Mellitus (T2DM). This association contributes to increased morbidity and mortality, elevated healthcare costs, and diminished quality of life. Consequently, preventing or delaying the onset and recurrence of AF is crucial for reducing the incidence of complications. Sodium-glucose cotransporter 2 inhibitors (SGLT2is), due to their multifaceted pharmacological actions, have been proposed as potential therapeutic agents in the management of AF. However, current evidence from both animal models and clinical studies remains inconclusive. This narrative literature review aims to provide a comprehensive analysis of existing evidence on the impact of SGLT2is on the prevalence, incidence of new-onset, and recurrence of AF in diabetic populations and patients with HF. Numerous observational studies, predominantly retrospective, suggest a consistent reduction in AF risk with SGLT2is, while randomized controlled trials (RCTs) have yielded mixed results, with some demonstrating benefits and others not reaching statistical significance. The heterogeneity in study outcomes, population characteristics, follow-up duration, and specific SGLT2is used, as well as potential biases, underscore the need for further extensive and rigorous RCTs to establish definitive conclusions and elucidate the underlying mechanisms.
心房颤动（AF）是全球成年人中最常见的心律失常，常与心力衰竭（HF）和2型糖尿病（T2DM）等合并症同时出现。这种关联导致发病率和死亡率增加、医疗成本上升以及生活质量下降。因此，预防或延缓房颤的发生和复发对于降低并发症的发生率至关重要。钠-葡萄糖协同转运蛋白2抑制剂（SGLT2i）由于其多方面的药理作用，已被提议作为房颤管理中的潜在治疗药物。然而，目前来自动物模型和临床研究的证据仍不明确。这篇叙述性文献综述旨在全面分析现有证据，以了解SGLT2i对糖尿病患者和心力衰竭患者中房颤的患病率、新发和复发发生率的影响。大量观察性研究（主要是回顾性研究）表明，SGLT2i可使房颤风险持续降低，而随机对照试验（RCT）的结果则喜忧参半，一些研究显示出益处，而另一些研究则未达到统计学意义。研究结果、人群特征、随访时间以及所使用的特定SGLT2i的异质性，以及潜在的偏差，都强调需要进一步进行广泛而严格的RCT，以得出明确的结论并阐明潜在机制。
