Proietti, Riccardo 
ORCID: 0000-0003-4113-7030, Rivera-Caravaza, JM, Lopez-Galvez, Raquel, Harrison, SL ORCID: 0000-0002-8846-0946, Marin, F, Underhill, Paula, Shantsila, Eduard ORCID: 0000-0002-2429-6980, McDowell, Garry, Vinciguerra, Manlio, Davies, Rhys et al (show 3 more authors)
(2023)
Cerebrovascular, Cognitive and Cardiac Benefits of SGLT2 Inhibitors Therapy in Patients with Atrial Fibrillation and Type 2 Diabetes Mellitus: Results from a Global Federated Health Network Analysis
Journal of Clinical Medicine, 12 (8).
2814-.
ISSN 2077-0383, 2077-0383
Abstract
Background: Sodium-glucose co-transporter 2 inhibitors (SGLT2i) are effective anti-diabetic drugs improving cardiovascular outcomes in type 2 diabetes mellitus (T2DM) patients. This study investigated cardiovascular, cerebrovascular and cognitive outcomes of SGLT2i therapy in patients with atrial fibrillation (AF) and T2DM. Methods: Observational study using TriNetX, a global health research network of anonymised electronic medical records from real-world patients between January 2018 and December 2019. The network includes healthcare organisations globally but predominately in the United States. AF patients (ICD-10-CM code: I48) with T2DM were divided according to SGLT2i use or not, and balanced using propensity score matching (PSM). Patients were followed-up for 3-years. The primary endpoints were ischaemic stroke/transient ischemic attack (TIA), intracranial haemorrhage (ICH), and incident dementia. Secondary endpoints were incident heart failure and mortality. Results: We identified 89,356 AF patients with T2DM of which 5061 (5.7%) were taking a SGLT2i. After PSM, 5049 patients (mean age 66.7 ± 10.6 years; 28.9% female) were included in each group. At 3-years follow-up, the risk of ischaemic stroke/TIA was higher in patients not receiving SGLT2i (HR 1.12, 95% CI 1.01–1.24) and for ICH (HR 1.57, 95% CI 1.25–1.99) and incident dementia (HR 1.66, 95% CI 1.30–2.12). Incident heart failure (HR 1.50, 95% CI 1.34–1.68) and mortality (HR 1.77, 95% CI 1.58–1.99) risks were increased in AF patients not receiving SGLT2i. Conclusions: In our large ‘real world’ analysis of patients with concomitant AF and T2DM, SGLT2i reduced the risk of cerebrovascular events, incident dementia, heart failure and death.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | SGLT2, atrial fibrillation, dementia, stroke |
| Divisions: | Faculty of Health & Life Sciences Faculty of Health & Life Sciences > Faculty Management Office Faculty of Health & Life Sciences > Inst. Life Courses & Medical Sciences Faculty of Health & Life Sciences > Inst. Population Health |
| Depositing User: | Symplectic Admin |
| Date Deposited: | 25 Apr 2023 08:22 |
| Last Modified: | 16 Jun 2026 06:03 |
| DOI: | 10.3390/jcm12082814 |
| Open Access URL: | https://doi.org/10.3390/jcm12082814 |
| Related Websites: | |
| URI: | https://livrepository.liverpool.ac.uk/id/eprint/3169948 |
| Disclaimer: | The University of Liverpool is not responsible for content contained on other websites from links within repository metadata. Please contact us if you notice anything that appears incorrect or inappropriate. |
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