Arrhythmias & electrophysiology
Sodium–glucose cotransporter-2 inhibitors, glucagon-like peptide-1 receptor agonists, and incident atrial fibrillation in Type 2 diabetes: a population-based target trial emulation
Authors' conclusion
Among adults with type 2 diabetes, treatment strategies incorporating SGLT2i were associated with a lower risk of incident AF or atrial flutter than GLP-1RA without SGLT2i.
Study context
- Population
- Adults with T2DM, population-based healthcare data 2015–2025
- Participants
- 216,293 adults
- Exposure
- SGLT2i without GLP-1RA vs GLP-1RA without SGLT2i vs early combined therapy
- SGLT2i without GLP-1RAn = 114,572reference
- GLP-1RA without SGLT2in = 91,524
- Early combined therapyn = 10,197
- Outcome
- Incident atrial fibrillation (AF) or atrial flutter (cumulative incidence)
- Follow-up
- 5 years
Methodological detailspopulation-based cohort study, three-arm, landmark design, inverse probability of treatment weighting, competing mortality accounted for
- Population-based cohort study
- Three-arm
- Landmark design
- Inverse probability of treatment weighting
- Competing mortality accounted for
Main finding
As reported in the abstract
Cumulative AF or atrial flutter incidence
Relative risk (95% CI)
SGLT2i without GLP-1RA vs GLP-1RA without SGLT2i
0.88(0.83–0.94)
SGLT2i without GLP-1RA vs Early combined therapyrisk similar
1.00(0.84–1.19)
Observational data: associations, not effects.
Original publication
Sodium–glucose cotransporter-2 inhibitors, glucagon-like peptide-1 receptor agonists, and incident atrial fibrillation in Type 2 diabetes: a population-based target trial emulation. Eur J Prev Cardiol. Published 6 September 2026. doi:10.
Summarised from the published abstract; every number is checked against it