■二甲双胍对2型糖尿病患者房颤(AF)的影响尚不清楚。我们旨在探讨二甲双胍对房颤的影响,包括新发房颤和房颤负担,2型糖尿病患者使用起搏器。
■这项回顾性研究共纳入227例患者。基于阵发性房颤的存在,患者分为阵发性房颤组(n=80)和非房颤组(n=147).在非AF组中,在多变量Cox风险模型(风险比[HR]:0.36;95%置信区间[CI]:0.14-0.91;p=0.0311*)中,二甲双胍的使用与新发房颤的较低风险之间存在显着关联。性别,体重指数(BMI),饮酒,吸烟,左心房尺寸,肌酐,并发症,和毒品。阵发性房颤组,单变量分析显示房颤负荷与二甲双胍使用无相关性(p=0.817).此外,当调整使用二甲双胍时,年龄,性别,BMI,饮酒,吸烟,心血管疾病,心肌梗塞,心力衰竭,中风,多变量Cox风险模型中的射血分数,我们发现,与AF组(HR:0.31;95%CI:0.02-4.41;p=0.3879)相比,在总体(HR:0.28;95%CI:0.1-0.82;p=0.0202*)和非AF组(HR:0.19;95%CI:0.05-0.79;p=0.0223*)中,主要不良心血管事件(MACEs)的比例较低.
■在使用起搏器的2型糖尿病患者中,二甲双胍降低了新发房颤的概率,而不是解决房颤负担。此外,二甲双胍治疗可降低无AF的2型糖尿病患者的MACE发生率.
UNASSIGNED: The effects of metformin on atrial fibrillation (AF) in type 2 diabetes patients remain unclear. We aimed to explore the effects of metformin on AF, including new-onset AF and AF burden, in type 2 diabetes patients with pacemakers.
UNASSIGNED: This retrospective study included a total of 227 patients. Based on the presence of paroxysmal AF, the patients were divided into a paroxysmal AF group (n = 80) and a non-AF group (n = 147). In the non-AF group, a significant association was observed between metformin use and a lower risk of new-onset AF in multivariable Cox hazards models (hazard ratio [HR]: 0.36; 95 % confidence interval [CI]: 0.14-0.91; p = 0.0311*) when adjusted for age, sex, body mass index (BMI), drinking, smoking, left atrial dimension, creatinine, complications, and drugs. In the paroxysmal AF group, univariable analysis indicated no association between the AF burden and metformin use (p = 0.817). Furthermore, when adjusted for metformin use, age, sex, BMI, drinking, smoking, cardiovascular disease, myocardial infarction, heart failure, stroke, and ejection fraction in multivariable Cox hazards models, we found a lower proportion of major adverse cardiovascular events (MACEs) both in the total (HR: 0.28; 95 % CI: 0.1-0.82; p = 0.0202*) and the non-AF group (HR: 0.19; 95 % CI: 0.05-0.79; p = 0.0223*) compared to that in the AF group (HR: 0.31; 95 % CI: 0.02-4.41; p = 0.3879).
UNASSIGNED: In type 2 diabetes patients with pacemakers, metformin reduced the probability of new-onset AF instead of addressing the AF burden. Furthermore, metformin therapy decreased the incidence of MACEs in type 2 diabetes patients without AF.