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Review
. 2024 Sep 12;13(18):5408.
doi: 10.3390/jcm13185408.

The Role of Sodium Glucose Co-Transporter 2 Inhibitors in Atrial Fibrillation: A Comprehensive Review

Panagiotis Stachteas  1 , Athina Nasoufidou  1 , Efstratios Karagiannidis  1 , Dimitrios Patoulias  2 , Paschalis Karakasis  1 , Sophia Alexiou  1 , Athanasios Samaras  1 , Georgios Zormpas  1 , George Stavropoulos  1 , Dimitrios Tsalikakis  3 , George Kassimis  1 , Christodoulos Papadopoulos  4 , Nikolaos Fragakis  1   2
Affiliations
Review

The Role of Sodium Glucose Co-Transporter 2 Inhibitors in Atrial Fibrillation: A Comprehensive Review

Panagiotis Stachteas et al. J Clin Med. .

Abstract

Atrial fibrillation (AF) is the most prevalent arrhythmia among adults worldwide, frequently co-occurring with comorbidities such as Heart Failure (HF) and Type 2 Diabetes Mellitus (T2DM). This association contributes to increased morbidity and mortality, elevated healthcare costs, and diminished quality of life. Consequently, preventing or delaying the onset and recurrence of AF is crucial for reducing the incidence of complications. Sodium-glucose cotransporter 2 inhibitors (SGLT2is), due to their multifaceted pharmacological actions, have been proposed as potential therapeutic agents in the management of AF. However, current evidence from both animal models and clinical studies remains inconclusive. This narrative literature review aims to provide a comprehensive analysis of existing evidence on the impact of SGLT2is on the prevalence, incidence of new-onset, and recurrence of AF in diabetic populations and patients with HF. Numerous observational studies, predominantly retrospective, suggest a consistent reduction in AF risk with SGLT2is, while randomized controlled trials (RCTs) have yielded mixed results, with some demonstrating benefits and others not reaching statistical significance. The heterogeneity in study outcomes, population characteristics, follow-up duration, and specific SGLT2is used, as well as potential biases, underscore the need for further extensive and rigorous RCTs to establish definitive conclusions and elucidate the underlying mechanisms.

Keywords: AF episodes; AF incidence; AF recurrence; SGLT-2 inhibitors; antiarrhythmic; atrial arrhythmias; gliflozins.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
The potential underlying pathological mechanisms involved in the antiarrhythmic properties of SGLT2is.
See this image and copyright information in PMC

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