Abdelhadi Naser A, Ragab Khaled Mohamed, Elkholy Mohammed, Koneru Jayanthi, Ellenbogen Kenneth A, Pillai Ajay
Division of Cardiac Electrophysiology, Virginia Commonwealth University, Richmond, Virginia, USA.
Faculty of Medicine, Minia University, Minia, Egypt.
J Cardiovasc Electrophysiol. 2025 Mar;36(3):673-682. doi: 10.1111/jce.16544. Epub 2025 Jan 9.
Atrial fibrillation (AF) is the most common cause of arrhythmia-induced cardiomyopathy. Effective management strategies include medical therapy for rate and rhythm control, catheter ablation (CA), and goal-directed medical therapy. Sodium-glucose co-transporter 2 inhibitors (SGLT2i), a novel class of antidiabetic drugs, have shown a promising impact in reducing cardiovascular events in diabetic and nondiabetic heart failure (HF) patients. It is unclear what impact SGLT2i use may have on AF recurrence following CA. To evaluate the effects of SGLT2i on preventing AF recurrence following CA and its impact on other cardiovascular outcomes. We performed a comprehensive literature search through multiple search engines (PubMed, Scopus, Web of Science, and Cochrane) to include eligible studies using the appropriate keywords until 10 April 2024. Our search yielded nine eligible studies with 16 857 patients. Our analysis reveals a significant reduction in AF recurrence after CA among patients receiving SGLT2i compared to non-SGLT2i medications (RR = 0.72, 95% CI [0.67-0.78], p < 0.00001). Additionally, SGLT2i therapy was associated with decreased all-cause hospitalizations and reduced risk of ischemic stroke. However, no significant difference in all-cause mortality was observed between SGLT2i and non-SGLT2i groups. Our study found that SGLT2 inhibitors significantly reduced AF recurrence post-CA in diabetic patients. Moreover, SGLT2i use was associated with lowered hospitalization and ischemic stroke risk. Though no significant difference in mortality was noted, the decrease in hospitalization suggests a possible favorable effect on cardiovascular events.
心房颤动（AF）是心律失常性心肌病最常见的病因。有效的管理策略包括控制心率和节律的药物治疗、导管消融（CA）以及目标导向的药物治疗。钠-葡萄糖协同转运蛋白2抑制剂（SGLT2i）是一类新型抗糖尿病药物，已显示出在降低糖尿病和非糖尿病心力衰竭（HF）患者心血管事件方面具有良好前景。目前尚不清楚使用SGLT2i对CA术后房颤复发有何影响。为评估SGLT2i对预防CA术后房颤复发的效果及其对其他心血管结局的影响。我们通过多个搜索引擎（PubMed、Scopus、Web of Science和Cochrane）进行了全面的文献检索，以纳入使用适当关键词的符合条件的研究，检索截至2024年4月10日。我们的检索得到了9项符合条件的研究，共16857例患者。我们的分析显示，与未使用SGLT2i药物的患者相比，接受SGLT2i治疗的患者CA术后房颤复发显著减少（RR = 0.72，95%CI [0.67 - 0.78]，p < 0.00001）。此外，SGLT2i治疗与全因住院率降低和缺血性中风风险降低相关。然而，SGLT2i组和非SGLT2i组在全因死亡率方面未观察到显著差异。我们的研究发现，SGLT2抑制剂可显著降低糖尿病患者CA术后的房颤复发率。此外，使用SGLT2i与住院率降低和缺血性中风风险降低相关。尽管在死亡率方面未发现显著差异，但住院率的降低表明对心血管事件可能有有利影响。
