Longer and better lives for patients with atrial fibrillation: the 9th AFNET/EHRA consensus conference

EP Europace, Journal Year: 2024, Volume and Issue: 26(4)

Published: March 22, 2024

Abstract Aims Recent trial data demonstrate beneficial effects of active rhythm management in patients with atrial fibrillation (AF) and support the concept that a low arrhythmia burden is associated risk AF-related complications. The aim this document to summarize key outcomes 9th AFNET/EHRA Consensus Conference Atrial Fibrillation NETwork (AFNET) European Heart Rhythm Association (EHRA). Methods results Eighty-three international experts met Münster for 2 days September 2023. Key findings are as follows: (i) Active should be part default initial treatment all suitable AF. (ii) Patients device-detected AF have stroke. Anticoagulation prevents some strokes also increases major but non-lethal bleeding. (iii) More research needed improve stroke prediction AF, especially those burden. Biomolecules, genetics, imaging can this. (iv) presence trigger systematic workup comprehensive concomitant cardiovascular conditions. (v) Machine learning algorithms been used detection or likely development Cooperation between clinicians scientists leverage potential science applications Conclusions lower other events than high Combining control, anticoagulation, rate therapy conditions lives

Language: Английский

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Differing Efficacy of Dapagliflozin Versus Empagliflozin on the Risk of Incident Atrial Fibrillation in Patients With Type 2 Diabetes: A Real‐World Observation Using a Nationwide, Population‐Based Cohort

Journal of the American Heart Association, Journal Year: 2024, Volume and Issue: 13(3)

Published: Jan. 23, 2024

Background Meta‐analyses of large clinical trials investigating SGLT2 (sodium‐glucose cotransporter‐2) inhibitors have suggested their protective effects against atrial fibrillation in patients with type 2 diabetes. However, the results were predominantly driven from involving dapagliflozin. Methods and Results We used a nationwide, population‐based cohort diabetes who initiated either dapagliflozin or empagliflozin between May 2016 December 2018. An active‐comparator, new‐user design was used, groups matched using propensity scores. The primary outcome incident nonvalvular fibrillation, which analyzed both main intention‐to‐treat sensitivity analysis that censored skipped medications for ≥30 days. Men ≥55 years age women ≥60 ≥1 traditional risk factor those established cardiovascular disease categorized as high group. Patients not included high‐risk group low risk. After 1:1 propensity‐score matching, total 137 928 (mean age, 55 years; 58% men) followed up 2.2±0.6 years. significantly lower (hazard ratio [HR], 0.885 [95% CI, 0.789–0.992]) analyses (HR, 0.835 0.719–0.970]). Notably, this consistent groups. There no effect modification by sex, body mass index, duration diabetes, renal function. Conclusions This real‐world, study demonstrates may developing than empagliflozin.

Language: Английский

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Efficacy and safety profile of SGLT2 inhibitors in the elderly: How is the benefit/risk balance?

Diabetes & Metabolism, Journal Year: 2023, Volume and Issue: 49(2), P. 101419 - 101419

Published: Jan. 11, 2023

Language: Английский

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GLP-1 Receptor Agonists and SGLT2 Inhibitors in Type 2 Diabetes: Pleiotropic Cardiometabolic Effects and Add-on Value of a Combined Therapy

Drugs, Journal Year: 2024, Volume and Issue: unknown

Published: Sept. 28, 2024

Language: Английский

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Risks of stroke, its subtypes and atrial fibrillation associated with glucagon-like peptide 1 receptor agonists versus sodium-glucose cotransporter 2 inhibitors: a real-world population-based cohort study in Hong Kong

Cardiovascular Diabetology, Journal Year: 2023, Volume and Issue: 22(1)

Published: Feb. 24, 2023

There are limited data on head-to-head comparative risk of stroke between sodium-glucose cotransporter 2 inhibitors (SGLT2i) and glucagon-like peptide-1 receptor agonists (GLP-1RA). We compared with its subtypes incident atrial fibrillation (AF) them.A population-based, retrospective cohort patients type diabetes 2008 2020 were identified from the electronic health records Hong Kong Hospital Authority. Patients who received SGLT2i or GLP-1RA matched pairwise by propensity score. Risks AF evaluated hazard ratios (HRs) Cox proportional regression models.A total 5840 (2920 users; 2920 users) included (mean age 55.5 years, 56.1% men, mean HbA1c 8.9% duration 13.7 years). Upon median follow-up 17 months, there 111 (1.9%) events (SGLT2i: 62, 2.1%; GLP-1RA: 49 1.7%). users had comparable all as (HR 1.46, 95% CI 0.99-2.17, p = 0.058). higher ischemic 1.53, 1.01-2.33, 0.044) but similar hemorrhagic to users. Although was associated lower 0.43, 0.23-0.79, 0.006), cardioembolic similar.Our real-world study demonstrated that use stroke, despite association AF. no significant difference in risk. may be preferred agent for at stroke.

Language: Английский

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Anti-Inflammation and Anti-Oxidation: The Key to Unlocking the Cardiovascular Potential of SGLT2 Inhibitors and GLP1 Receptor Agonists

Antioxidants, Journal Year: 2023, Volume and Issue: 13(1), P. 16 - 16

Published: Dec. 20, 2023

Type 2 diabetes mellitus (T2DM) is a prevalent and complex metabolic disorder associated with various complications, including cardiovascular diseases. Sodium-glucose co-transporter inhibitors (SGLT2i) glucagon-like peptide 1 receptor agonists (GLP1-RA) have emerged as novel therapeutic agents for T2DM, primarily aiming to reduce blood glucose levels. However, recent investigations unveiled their multifaceted effects, extending beyond glucose-lowering effect. SGLT2i operate by inhibiting the SGLT2 in kidneys, facilitating excretion of through urine, leading reduced levels, while GLP1-RA mimic action GLP1 hormone, stimulating glucose-dependent insulin secretion from pancreatic islets. Both shown remarkable benefits reducing major events patients without T2DM. This comprehensive review explores expanding horizons improving health. It delves into latest research, highlighting effects these drugs on heart physiology metabolism. By elucidating diverse mechanisms emerging evidence, this aims recapitulate potential options health traditional role managing

Language: Английский

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Do SGLT2 inhibitors and GLP-1 receptor agonists modulate differently the risk of stroke ? Discordance between randomised controlled trials and observational studies

Diabetes & Metabolism, Journal Year: 2023, Volume and Issue: 49(5), P. 101474 - 101474

Published: Sept. 1, 2023

Language: Английский

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SGLT2 Inhibitors vs GLP-1 Receptor Agonists and Clinical Outcomes in Patients With Diabetes With/Without Atrial Fibrillation

The Journal of Clinical Endocrinology & Metabolism, Journal Year: 2024, Volume and Issue: unknown

Published: March 10, 2024

The coexistence of diabetes mellitus and atrial fibrillation (AF) is associated with substantial risks adverse cardiovascular events.

Language: Английский

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Glucose-lowering agents and risk of ventricular arrhythmias and sudden cardiac death: A comprehensive review ranging from sulphonylureas to SGLT2 inhibitors

Diabetes & Metabolism, Journal Year: 2022, Volume and Issue: 48(6), P. 101405 - 101405

Published: Nov. 1, 2022

Language: Английский

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Influencing factors of stroke in patients with type 2 diabetes: A systematic review and meta-analysis

PLoS ONE, Journal Year: 2024, Volume and Issue: 19(6), P. e0305954 - e0305954

Published: June 24, 2024

Background Stroke stands as a significant macrovascular complication among individuals with Type 2 diabetes mellitus (T2DM), often resulting in the primary cause of mortality and disability within this patient demographic. Presently, numerous studies have been conducted to investigate underlying causes stroke T2DM, yet findings exhibit inconsistencies. Objective This paper aims consolidate summarize available evidence concerning influential factors contributing patients diagnosed T2DM. Methods We comprehensive search across multiple databases, including Cochrane Library, PubMed, Web Of Science, Embase, China Biology Medicine (CBM), National Knowledge Infrastructure (CNKI), Wanfang Weipu up August 2023. Google Scholar was also searched retrieve gray literature. calculated odds ratios (OR) 95% confidence intervals (CI) using Stata software. Results Our analysis encompassed 43 observational studies, exploring sociodemographic, biochemical, complications, hypoglycemic agent categories. The identified several risk for T2DM: age, gender, T2DM duration, hypertension, body-mass index (BMI), smoking, Glycated hemoglobin (HbA1c), estimated Glomerular Filtration Rate (eGFR), albuminuria, Triglycerides (TG), Low density lipoprotein cholesterol (LDL-C), Coronary heart disease (CHD), Atrial fibrillation (AF), diabetic retinopathy (DR), Peripheral vascular (PVD), carotid plaque. Conversely, exercise, High (HDL-C), metformin (MET), pioglitazone, combination therapy emerged protective factors. Conclusion study underscores multitude influencing people patients, which microvascular complications play an most important role. Therefore, we emphasize importance screening However, due limitations arising from number articles reviewed, there remain areas where clarity is lacking. Further research efforts are warranted expand upon reinforce our current findings.

Language: Английский

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