PDF(Pubmed)
Abstract：
UNASSIGNED: Sodium-glucose cotransporter 2 inhibitors (SGLT2i) are a class of widely used hypoglycemic agents for the treatment of type 2 diabetes mellitus (T2DM). In addition to lowering blood glucose, SGLT2i protects the heart and kidney, significantly reduces cardiovascular events, and delays the progression of heart failure and chronic kidney disease. However, previous studies have not exhaustively discussed the association between SGLT2i and the risk of developing cardiac arrhythmias. The purpose of this study is to assess the association of SGLT2i with cardiac arrhythmias in patients with T2DM and without T2DM in cardiovascular outcome trials (CVOTs).
UNASSIGNED: We performed a meta-analysis and systematic review of CVOTs that compared SGLT2i with placebo. MEDLINE, Web of Science, The Cochrane Library and Embase were systematically searched from inception to December 2022. We included CVOTs reporting cardiovascular or renal outcomes with a follow-up duration of at least 6 months.
UNASSIGNED: A total of 12 CVOTs with 77,470 participants were included in this meta-analysis (42,016 SGLT2i vs 35,454 control), including patients with T2DM, heart failure (HF), or chronic kidney disease (CKD). Follow-up duration ranged from 9 months to 5.65 years. Medications included empagliflozin, canagliflozin, dapagliflozin and ertugliflozin. SGLT2i were associated with a lower risk of tachycardia (risk ratio (RR) 0.86; 95% confidence interval (CI) 0.79-0.95), supraventricular tachycardia (SVT; RR 0.84; 95% CI 0.75-0.94), atrial fibrillation (AF; RR 0.86; 95% CI 0.75-0.97) and atrial flutter (AFL; RR 0.75; 95% CI 0.57-0.99) in patients with T2DM, HF and CKD. SGLT2i could also reduce the risk of cardiac arrest in CKD patients (RR 0.50; 95% CI 0.26-0.95). Besides, SGLT2i therapy was not associated with a lower risk of ventricular arrhythmia and bradycardia.
UNASSIGNED: SGLT2i therapy is associated with significantly reduced the risk of tachycardia, SVT, AF, and AFL in patients with T2DM, HF, and CKD. In addition, SGLT2i could also reduce the risk of cardiac arrest in CKD patients. Further researches are needed to fully elucidate the antiarrhythmic mechanism of SGLT2i.
UNASSIGNED: We performed a meta-analysis and systematic review of CVOTs that compared SGLT2i with placebo. MEDLINE, Web of Science, The Cochrane Library and Embase were systematically searched from inception to December 2022. We included CVOTs reporting cardiovascular or renal outcomes with a follow-up duration of at least 6 months.
UNASSIGNED: A total of 12 CVOTs with 77,470 participants were included in this meta-analysis (42,016 SGLT2i vs 35,454 control), including patients with T2DM, heart failure (HF), or chronic kidney disease (CKD). Follow-up duration ranged from 9 months to 5.65 years. Medications included empagliflozin, canagliflozin, dapagliflozin and ertugliflozin. SGLT2i were associated with a lower risk of tachycardia (risk ratio (RR) 0.86; 95% confidence interval (CI) 0.79-0.95), supraventricular tachycardia (SVT; RR 0.84; 95% CI 0.75-0.94), atrial fibrillation (AF; RR 0.86; 95% CI 0.75-0.97) and atrial flutter (AFL; RR 0.75; 95% CI 0.57-0.99) in patients with T2DM, HF and CKD. SGLT2i could also reduce the risk of cardiac arrest in CKD patients (RR 0.50; 95% CI 0.26-0.95). Besides, SGLT2i therapy was not associated with a lower risk of ventricular arrhythmia and bradycardia.
UNASSIGNED: SGLT2i therapy is associated with significantly reduced the risk of tachycardia, SVT, AF, and AFL in patients with T2DM, HF, and CKD. In addition, SGLT2i could also reduce the risk of cardiac arrest in CKD patients. Further researches are needed to fully elucidate the antiarrhythmic mechanism of SGLT2i.
摘要：
■钠-葡萄糖协同转运蛋白2抑制剂(SGLT2i)是一类广泛用于治疗2型糖尿病(T2DM)的降血糖药。除了降低血糖，SGLT2i保护心脏和肾脏，显著减少心血管事件，延缓心力衰竭和慢性肾病的进展。然而,以往的研究并未详尽讨论SGLT2i与发生心律失常风险之间的关联.这项研究的目的是评估SGLT2i与心血管结局试验（CVOTs）中T2DM和非T2DM患者心律失常的相关性。
■我们对CVOT进行了荟萃分析和系统评价，将SGLT2i与安慰剂进行了比较。MEDLINE,WebofScience,从成立到2022年12月，对Cochrane图书馆和Embase进行了系统搜索。我们纳入了报告心血管或肾脏结局的CVOT，随访时间至少为6个月。
■本次荟萃分析共纳入12个CVOT，其中77,470名参与者（42,016SGLT2i对35,454名对照），包括T2DM患者，心力衰竭(HF),或慢性肾病（CKD）。随访时间为9个月至5.65年。药物包括empagliflozin,Canagliflozin,dapagliflozin和ertugliflozin.SGLT2i与较低的心动过速风险相关（风险比（RR）0.86;95％置信区间（CI）0.79-0.95），室上性心动过速(室上性心动过速;RR0.84;95%CI0.75-0.94),2型糖尿病患者的房颤(AF;RR0.86;95%CI0.75-0.97)和房扑(AFL;RR0.75;95%CI0.57-0.99),HF和CKD。SGLT2i还可以降低CKD患者心脏骤停的风险(RR0.50;95%CI0.26-0.95)。此外,SGLT2i治疗与室性心律失常和心动过缓的风险较低无关。
■SGLT2i治疗与显著降低心动过速风险相关，SVT,AF,2型糖尿病患者的AFL，HF,CKD。此外,SGLT2i还可以降低CKD患者心脏骤停的风险。需要进一步的研究来充分阐明SGLT2i的抗心律失常机制。
■我们对CVOT进行了荟萃分析和系统评价，将SGLT2i与安慰剂进行了比较。MEDLINE,WebofScience,从成立到2022年12月，对Cochrane图书馆和Embase进行了系统搜索。我们纳入了报告心血管或肾脏结局的CVOT，随访时间至少为6个月。
■本次荟萃分析共纳入12个CVOT，其中77,470名参与者（42,016SGLT2i对35,454名对照），包括T2DM患者，心力衰竭(HF),或慢性肾病（CKD）。随访时间为9个月至5.65年。药物包括empagliflozin,Canagliflozin,dapagliflozin和ertugliflozin.SGLT2i与较低的心动过速风险相关（风险比（RR）0.86;95％置信区间（CI）0.79-0.95），室上性心动过速(室上性心动过速;RR0.84;95%CI0.75-0.94),2型糖尿病患者的房颤(AF;RR0.86;95%CI0.75-0.97)和房扑(AFL;RR0.75;95%CI0.57-0.99),HF和CKD。SGLT2i还可以降低CKD患者心脏骤停的风险(RR0.50;95%CI0.26-0.95)。此外,SGLT2i治疗与室性心律失常和心动过缓的风险较低无关。
■SGLT2i治疗与显著降低心动过速风险相关，SVT,AF,2型糖尿病患者的AFL，HF,CKD。此外,SGLT2i还可以降低CKD患者心脏骤停的风险。需要进一步的研究来充分阐明SGLT2i的抗心律失常机制。
