The impact of sodium-glucose co-transporter-2 inhibitors on dementia and cardiovascular events in diabetic patients with atrial fibrillation.
Diabetes Metab Res Rev
; 40(2): e3775, 2024 Feb.
Article
en En
| MEDLINE
| ID: mdl-38340046
ABSTRACT
AIMS:
The effectiveness of sodium-glucose co-transporter-2 inhibitors (SGLT2i) on incident dementia in patients with diabetes and atrial fibrillation (AF) remains unknown. This study aimed to investigate the association between SGLT2i and the risk of incident dementia in diabetic patients with AF, and to explore the interactions with oral anticoagulants or dipeptidyl peptidase-4 inhibitors (DPP4i). MATERIALS ANDMETHODS:
We conducted a cohort study using Taiwan's National Health Insurance Research Database. Patients with diabetes and AFwithout a prior history of established cardiovascular diseases, were identified. Using propensity score matching, 810 patients receiving SGLT2i were matched with 1620 patients not receiving SGLT2i. The primary outcome was incident dementia, and secondary outcomes included composite cardiovascular events and mortality.RESULTS:
After up to 5 years of follow-up, SGLT2i use was associated with a significantly lower risk of incident dementia (hazard 0.71, 95% confidence interval 0.51-0.98), particularly vascular dementia (HR 0.44, 95% CI 0.24-0.82). SGLT2i was related to reduced risks of AF-related hospitalisation (HR 0.72, 95% CI 0.56-0.93), stroke (HR 0.75, 95% CI 0.60-0.94), and all-cause death (HR 0.33, 95% CI 0.24-0.44). The protective effects were consistent irrespective of the concurrent use of non-vitamin K antagonist oral anticoagulants (NOACs) or DPP4i.CONCLUSIONS:
In diabetic patients with AF, SGLT2i was associated with reduced risks of incident dementia, AF-related hospitalisation, stroke, and all-cause death. The protective effects were independent of either concurrent use of NOACs or DPP4i.Palabras clave
Texto completo:
1
Bases de datos:
MEDLINE
Asunto principal:
Fibrilación Atrial
/
Accidente Cerebrovascular
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Simportadores
/
Demencia
/
Diabetes Mellitus
/
Diabetes Mellitus Tipo 2
/
Inhibidores de la Dipeptidil-Peptidasa IV
/
Inhibidores del Cotransportador de Sodio-Glucosa 2
Tipo de estudio:
Etiology_studies
/
Incidence_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Límite:
Humans
Idioma:
En
Revista:
Diabetes Metab Res Rev
Asunto de la revista:
ENDOCRINOLOGIA
/
METABOLISMO
Año:
2024
Tipo del documento:
Article
País de afiliación:
Taiwán