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Dissecting the reduction in cardiovascular death with SGLT2 inhibitors: Potential contribution of effects on ventricular arrhythmias and sudden cardiac death?

Scheen, André

2022 • In Diabetes Epidemiology and Management, 8, p. 100107

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https://hdl.handle.net/2268/312553

DOI
10.1016/j.deman.2022.100107

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Keywords :

Cardiac arrhythmia; Heart failure; SGLT2 inhibitor; Sudden cardiac death; Type 2 diabetes; Ventricular fibrillation

Abstract :

[en] Type 2 diabetes is associated with a higher risk of cardiac arrhythmias, especially in presence of cardiovascular disease and/or heart failure. Ventricular arrhythmias (VA: tachycardia/fibrillation) may lead to sudden cardiac arrest/death (SCA/SCD). Sodium-glucose cotransporter type 2 inhibitors (SGLT2is) exert a remarkable protection against cardiovascular disease, especially hospitalisation for heart failure, yet their effects on malignant cardiac arrhythmias are poorly known. Nevertheless, findings derived from experimental animal and clinical studies suggested that SGLT2is could reduce the risk of not only supraventricular but also ventricular cardiac arrhythmias. A trend for less VA and SCA/SCD events was reported in post hoc analyses of randomised controlled trials/cardiovascular outcome trials versus placebo, yet statistical significance was not reached presumably because of too few events in both treatment groups. Retrospective observational cohort studies that reported malignant cardiac arrhythmias in patients treated with SGLT2is versus other glucose-lowering agents are scare, compared to the numerous ones that focused on atrial fibrillation/flutter. Further studies specifically devoted to the effects of SGLT2is on malignant cardiac arrhythmias are needed to confirm positive effects in patients with diabetes and/or heart failure and if possible to carefully dissect the underlying anti-arrhythmic protective mechanisms.

Disciplines :

Endocrinology, metabolism & nutrition
Cardiovascular & respiratory systems
Pharmacy, pharmacology & toxicology

Author, co-author :

Scheen, André ; Centre Hospitalier Universitaire de Liège - CHU > > Service de diabétologie, nutrition, maladies métaboliques

Language :

English

Title :

Dissecting the reduction in cardiovascular death with SGLT2 inhibitors: Potential contribution of effects on ventricular arrhythmias and sudden cardiac death?

Publication date :

2022

Journal title :

Diabetes Epidemiology and Management

eISSN :

2666-9706

Volume :

8

Pages :

100107

Peer reviewed :

Peer Reviewed verified by ORBi

Additional URL :

https://www.sciencedirect.com/science/article/pii/S2666970622000579

Available on ORBi :

since 01 February 2024

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