SGLT2 Inhibitors Linked to Lower Risk for AF in T2D
The use of SGLT2 inhibitors was associated with a reduced risk for atrial fibrillation (AF) in patients with type 2 diabetes (T2D).
METHODOLOGY:
SGLT2 inhibitors have been shown to provide therapeutic benefits to patients with heart failure and AF; however, data on their protective effect on AF in patients without heart failure are inconsistent.
Researchers conducted a retrospective case-control study in Germany to assess the association between the use of various antihyperglycemic medications between 2005 and 2023 and the diagnosis of AF in patients with T2D during the same period.
They used data from the Disease Analyzer database including 29,424 patients with T2D aged 40 years or older with an initial diagnosis of AF who were matched to an equal number of control patients without AF (mean age at the index date , 76 years; 46%-47% women; average diabetes duration prior to the index date for both cohorts, 6.8 years).
Antihyperglycemic therapies included metformin, sulfonylurea, GLP-1 receptor agonists (RAs), DPP-4 inhibitors, SGLT2 inhibitors, and insulin.
TAKEAWAY:
Treatment with SGLT2 inhibitors was associated with a reduced risk for AF (odds ratio [OR], 0.82; P < .01 per year of therapy).
< .01 per year of therapy). GLP-1 RAs were associated with a slightly reduced risk for AF (OR, 0.93; P < .01), with a stronger association among women (OR, 0.89), patients aged 71-80 years (OR, 0.88), and patients older than 80 years (OR, 0.81; P < .01 for all).
< .01), with a stronger association among women (OR, 0.89), patients aged 71-80 years (OR, 0.88), and patients older than 80 years (OR, 0.81; < .01 for all). The use of sulfonylurea was linked to a slightly increased risk for AF (OR, 1.09; P < .01), with the strongest association among patients younger than 70 years (OR, 1.18; P < .01).
< .01), with the strongest association among patients younger than 70 years (OR, 1.18; < .01). Patients with AF began SGLT2 inhibitor therapy on average 2.6 years before diagnosis, with the therapy lasting an average of 2.3 years.
IN PRACTICE:
'SGLT2i [inhibitors] and GLP-1 RA may provide an important, heretofore unknown effect of antidiabetic therapy: The prevention of AF, a cardiac condition of massive prevalence and severe impact for those affected,' the authors wrote.
SOURCE:
This study was led by Mark Luedde, MD, and Jamschid Sedighi, MD, of the University Hospital of Giessen and Marburg, Giessen, Germany. It was published online on June 03, 2025, in Diabetes, Obesity and Metabolism .
LIMITATIONS:
This study lacked data on the frequency and duration of AF episodes. The absence of data on cardiovascular disease severity may have affected the balance between groups. Potential bias due to the indication of oral antidiabetic treatments cannot be ruled out.
DISCLOSURES:
This study did not report any specific funding. The authors reported having no relevant conflicts of interest.
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