Zhongguo quanke yixue (Feb 2022)
Effect of Dapagliflozin on the Risk of New-onset Atrial Fibrillation during Hospitalization for Acute Myocardial Infarction in Patients with Type 2 Diabetes
Abstract
BackgroundAtrial fibrillation is a common complication of acute myocardial infarction with an incidence varying from 5% to 20%. New-onset atrial fibrillation developing after acute myocardial fibrillation indicates a significantly increased risk of death and stroke. Diabetes mellitus, as a shared risk factor in both acute myocardial infarction and atrial fibrillation, plays an important role in the development of acute myocardial infarction and atrial fibrillation. It has been reported that dapagliflozin, a new hypoglycemic agent, has a positive effect on lowering glucose. However, there are few data regarding its impact on the risk of atrial fibrillation after acute myocardial infarction in patients with diabetes.ObjectiveTo investigate the effect of dapagliflozin on the risk of new-onset atrial fibrillation after acute myocardial infarction in patients with type 2 diabetes mellitus.MethodsTotal 764 patients with type 2 diabetes mellitus admitted during December 2018 to June 2020 in Cardiovascular Department, the First Affiliated Hospital of Zhengzhou University for acute myocardial infarction were selected. The demographic data, echocardiographic indices and laboratory data were collected, and compared between participants with new-onset atrial fibrillation (n=188) and those without (n=576) . Multivariate Logistic regression analysis was used to assess the impact of dapagliflozin on the risk of new-onset atrial fibrillation after acute myocardial infarction.ResultsPatients with new-onset atrial fibrillationhad older mean age, higher male proportion, and proportion of smokers, higher mean levels of glycosylated hemoglobin, left atrial diameter, NT-proBNP and C-reactive protein, and lower mean levels of systolic blood pressure and high-density lipoprotein, as well as lower prevalence of using insulinand dapagliflozinthan those without (P<0.05) . Multivariate Logistic regression analysis found that dapagliflozin was associated with a 34% reduced risk for new-onset atrial fibrillation after acute myocardial infarction in patients with type 2 diabetes mellitus 〔OR=0.66, 95%CI (0.57, 0.91) , P=0.008〕.ConclusionDapagliflozin may be associated with a lower risk of new-onset atrial fibrillation after acute myocardial infarction in type 2 diabetics.
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