Canagliflozin and atrial fibrillation in type 2 diabetes mellitus: A secondary analysis from the CANVAS Program and CREDENCE trial and meta-analysis
Diabetes Obes Metab. 2022;24:1927–1938 DOI: 10.1111/dom.14772
The effect of sodium-glucose cotransporter-2 inhibitors (SGLT2i) on AF/AFL was previously unclear as event-driven randomised trials have not assessed AF/AFL as a prespecified endpoint. Furthermore, results from post-hoc and secondary analyses have indicated a potentially protective effect with dapagliflozin, but no reduction with empagliflozin.
The current pooled analysis did not demonstrate a significant effect of canagliflozin on the incidence of AF/AFL events; however, a possible reduction in AF/AFL was seen in those with no prior history. A meta-analysis of data from CANVAS, CREDENCE, DECLARE-TIMI 58 and DAPA-HF was conducted and a 19% reduction in AF/AFL incidence was seen.