It is advisable to use it as soon as possible! SGLT-2i can reduce the risk of "atrial fibrillation" in elderly diabetics

Based on established inclusion criteria, the study included more than 200,000 older people with type 2 diabetes (mean age 72 years, 53.
4% female).

After the propensity score matched, 149736 (74,868 pairs) received SGLT2 inhibitors or DPP-4i, and 160,950 (80,475 pairs) received SGLT2 inhibitors or glucagon-like peptide-1 receptor agonists (GLP-1RA).

The primary outcome of the study was the risk
of developing AF.

The incidence of AF was lower in the SGLT2 inhibitor group

The incidence of AF was lower in the SGLT2 inhibitor group compared with the DPP-4i group (HR 0.
82, 95% CI 0.
76 to 0.
89; 16.
8 per 1000 person-years versus 20.
5 per 1000 person-years).

The incidence of AF was lower in the SGLT2 inhibitor group compared with the GLP-1RA receptor agonist group (HR 0.
9, 95% CI 0.
83 to 0.
98; 17 versus 18.
7 per 1000 person-years).

Table 1: Main findings

Analysis of subgroups was consistent with the above, with analysis of age, sex, history of heart failure, or history of atherosclerotic cardiovascular disease showing no effect heterogeneity
between SGLT2 inhibitors and the onset of AF.

Figure 1 Subgroup analysis results

brief summary

These results confirm that SGLT-2i reduces the risk of AF in older patients with type 2 diabetes compared with DPP-4i or GLP-1RA, suggesting the potential benefits
of timely initiation of SGLT-2i therapy in older patients with type 2 diabetes.

References: Zhuo M, D'Andrea E, Paik JM, et al.
Association of Sodium-Glucose Cotransporter-2 Inhibitors With Incident Atrial Fibrillation in Older Adults With Type 2Diabetes .
JAMA Netw Open.
2022; 5(10):e2235995.
Published 2022 Oct 3.
doi:10.
1001/jamanetworkopen.
2022.
35995