Association of type 2 diabetes mellitus with the development of new-onset atrial fibrillation in patients with non-ischemic dilated cardiomyopathy: impact of SGLT2 inhibitors.

Abstract

The aim of this study was to investigate the association of type 2 diabetes mellitus (T2DM) with the development of new-onset atrial fibrillation (AF) for non-ischemic dilated cardiomyopathy (DCM) patients. We also tested the hypothesis that sodium glucose cotransporter type 2 (SGLT2) inhibitors reduce the risk of development of new-onset AF for non-ischemic DCM patients. We retrospectively studied 210 patients with non-ischemic DCM and sinus rhythm, mean age of 59.0 ± 16.7 years and left ventricular ejection fraction of 31.0 ± 8.2% (all < 45%). T2DM was identified in 60 patients (28.6%), and the remaining 150 patients (71.4%) were classified as non-T2DM patients. New-onset AF occurred in 21 patients (10.0%) over a median follow-up of 6.1 years. Kaplan-Meier curve analysis showed that non-ischemic DCM patients without T2DM experienced fewer occurrences of the development of new-onset AF compared with those with T2DM (log-rank p = 0.0003). Furthermore, global longitudinal strain in patients who showed development of new-onset AF was significantly lower than that in those whose sinus rhythm was preserved (6.4 ± 1.4% vs. 7.7 ± 2.2%, p = 0.01). Of the 60 non-ischemic DCM patients with T2DM, those treated with SGLT2 inhibitors experienced fewer occurrences of the development of new-onset AF than did those not treated with SGLT2 inhibitors (log-rank p = 0.040). T2DM is associated with the development of new-onset AF in non-ischemic DCM patients, and treatment with SGLT2 inhibitors can significantly reduce the development of new-onset AF. Our findings may thus offer a new insight into the management of non-ischemic DCM patients with T2DM.

• Authors: Hidekazu Tanaka, Kazuhiro Tatsumi, Hiroki Matsuzoe, Fumitaka Soga, Kensuke Matsumoto, Ken-Ichi Hirata
• Journal: The international journal of cardiovascular imaging (Int J Cardiovasc Imaging) Vol. 37 Issue 4 Pg. 1333-1341 (Apr 2021) ISSN: 1875-8312 [Electronic] United States
• PMID: 33392879 (Publication Type: Journal Article)

Chemical References

• Sodium-Glucose Transporter 2 Inhibitors

Topics

• Adult
• Aged
• Atrial Fibrillation (diagnosis, etiology, prevention & control)
• Cardiomyopathy, Dilated (complications, diagnostic imaging)
• Diabetes Mellitus, Type 2 (complications, diagnosis, drug therapy)
• Female
• Humans
• Male
• Middle Aged
• Progression-Free Survival
• Retrospective Studies
• Risk Assessment
• Risk Factors
• Sodium-Glucose Transporter 2 Inhibitors (therapeutic use)
• Time Factors