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Ong HT, Teo YH, Teo YN, et al. Effects of Sodium/Glucose Cotransporter Inhibitors on Atrial Fibrillation and Stroke: A Meta-Analysis. J Stroke Cerebrovasc Dis. 2021;31(1):106159doi: 10.1016/j.jstrokecerebrovasdis.2021.106159.
Ong, H. T., Teo, Y. H., Teo, Y. N., Syn, N. L., Wee, C. F., Leong, S., Yip, A. S. Y., See, R. M., Ting, A. Z. H., Chia, A. Z., Cheong, A. J. Y., Tan, B. Y., Ho, J. S., Yeo, L. L., Leow, A. S., Yeo, T. C., Wong, R. C., Chai, P., Kojodjojo, P., & Sia, C. H. (2021). Effects of Sodium/Glucose Cotransporter Inhibitors on Atrial Fibrillation and Stroke: A Meta-Analysis. Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association, 31(1), 106159. https://doi.org/10.1016/j.jstrokecerebrovasdis.2021.106159
Ong, How Ting, et al. "Effects of Sodium/Glucose Cotransporter Inhibitors on Atrial Fibrillation and Stroke: A Meta-Analysis." Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association vol. 31,1 (2021): 106159. doi: https://doi.org/10.1016/j.jstrokecerebrovasdis.2021.106159
Ong HT, Teo YH, Teo YN, Syn NL, Wee CF, Leong S, Yip ASY, See RM, Ting AZH, Chia AZ, Cheong AJY, Tan BY, Ho JS, Yeo LL, Leow AS, Yeo TC, Wong RC, Chai P, Kojodjojo P, Sia CH. Effects of Sodium/Glucose Cotransporter Inhibitors on Atrial Fibrillation and Stroke: A Meta-Analysis. J Stroke Cerebrovasc Dis. 2021 Oct 21;31(1):106159. doi: 10.1016/j.jstrokecerebrovasdis.2021.106159. Epub 2021 Oct 21. PMID: 34689051.
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J Stroke Cerebrovasc Dis. 2021 Oct 21;31(1):106159. doi: 10.1016/j.jstrokecerebrovasdis.2021.106159. Epub 2021 Oct 21.

Effects of Sodium/Glucose Cotransporter Inhibitors on Atrial Fibrillation and Stroke: A Meta-Analysis.

Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association

How Ting Ong, Yao Hao Teo, Yao Neng Teo, Nicholas Lx Syn, Caitlin Fern Wee, Shariel Leong, Alicia Swee Yan Yip, Ray Meng See, Adriel Zhi Hen Ting, Alys Zq Chia, Alex Jia Yang Cheong, Benjamin Yong-Qiang Tan, Jamie Sin-Ying Ho, Leonard Leong-Litt Yeo, Aloysius Sheng-Ting Leow, Tiong-Cheng Yeo, Raymond Cc Wong, Ping Chai, Pipin Kojodjojo, Ching-Hui Sia

Affiliations

  1. Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
  2. Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Division of Neurology, University Medicine Cluster, National University Health System, Singapore.
  3. Academic Foundation Programme, North Middlesex University Hospital NHS Trust, United Kingdom.
  4. Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Department of Cardiology, National University Heart Centre Singapore, 1E Kent Ridge Road, NUHS Tower Block Level 9, 119228, Singapore.
  5. Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Department of Cardiology, National University Heart Centre Singapore, 1E Kent Ridge Road, NUHS Tower Block Level 9, 119228, Singapore. Electronic address: [email protected].

PMID: 34689051 DOI: 10.1016/j.jstrokecerebrovasdis.2021.106159

Abstract

OBJECTIVES: Recent clinical trials have shown the potential of sodium glucose cotransporter (SGLT) 2 inhibitors to reduce the risk of atrial fibrillation but not stroke. We conducted a systematic review and meta-analysis to clarify if SGLT2 or combined SGLT1/2 inhibitors affect the risk of atrial fibrillation and stroke in patients regardless of diabetic status.

MATERIALS AND METHODS: Four electronic databases were searched on 21st November 2020 for studies evaluating outcomes of stroke and atrial fibrillation with SGLT2 or combined SGLT1/2 inhibitors in both diabetic and non-diabetic patients. Both random and fixed effect, pair-wise meta-analysis models were used to summarize the results of the studies.

RESULTS: A total of 13 placebo-controlled, randomized-controlled trials were included. Eight trials comprising 35,702 patients were included in the analysis of atrial fibrillation outcomes and eight trials comprising 47,910 patients were included in the analysis of stroke outcomes. Patients on SGLT inhibitors, particularly SGLT2 inhibitors, had lower odds of atrial fibrillation (Peto odds ratio [95% confidence interval] = 0.76 [0.63-0.92]) compared to placebo. This effect remained significant with a follow-up duration longer than 1 year, in studies utilizing dapagliflozin, patients with type 2 diabetes mellitus, and patients with cardiovascular disease. No difference was observed in the odds of atrial fibrillation in patients with baseline heart failure. No effect was seen on the risk of stroke in patients taking SGLT inhibitors.

CONCLUSIONS: SGLT2 inhibitors significantly reduced the odds of atrial fibrillation in diabetic patients. However, SGLT inhibitors did not significantly affect the risk of stroke.

Copyright © 2021 Elsevier Inc. All rights reserved.

Keywords: Atrial fibrillation; Meta-analysis; Sodium/glucose cotransporter inhibitor; Stroke

Conflict of interest statement

Declaration of Competing Interest None

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