Arrhythmias & electrophysiology
Prevention of atrial fibrillation with SGLT2 inhibitors across the spectrum of cardiovascular disorders: a meta-analysis of randomized controlled trials
Pooled result · AF development (overall)Result — go to the resultRelative risk 0.86 95% CI 0.77–0.96Authors' conclusion
Sodium-glucose co-transporter 2 inhibitors prevent AF. Their protective effect was confirmed in the HFrEF subgroup, but not in RCTs recruiting patients with HFmrEF/HFpEF, possibly indicating a different pathophysiology leading to AF among these conditions. However, given the limitations of a trial-level analysis, these findings are exploratory, pending confirmation from patient-level data.
Study context
- Population
- Randomized controlled trials comparing SGLT2 inhibitors with placebo and reporting the number of patients who developed atrial fibrillation (AF) in each armHeart failure with reduced ejection fraction (HFrEF) 9,141 · HFmrEF/HFpEF 12,877
- Participants
- 112,031 participants52 randomized controlled trials (RCTs)
- Comparison
- SGLT2 inhibitors with placebo
- Outcome
- AF development (overall)
Methodological detailsrandom-effects model
- Random-effects model
Pooled result
As reported in the abstract
Relative risk
0.86
95% CI 0.77–0.96
SGLT2 inhibitorsvs placebo
RR 0.86 (95% CI 0.77–0.96)
Further pooled results
AF development by HF subgroup
- AF-preventive ability preserved in RCTs recruiting patients with HFrEF
- AF-preventive ability not preserved in RCTs recruiting subjects with HFmrEF/HFpEF
- P-value for group difference = 0.01
Meta-regression of AF-preventive efficacy
- Reduced efficacy when more patients with hypertension or higher EF were enrolled
- P < 0.01 for both
Original publication
Prevention of atrial fibrillation with SGLT2 inhibitors across the spectrum of cardiovascular disorders: a meta-analysis of randomized controlled trials. Eur Heart J Cardiovasc Pharmacother. Published 4 June 2025. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →