Evidence map›Paper›PMID 32847602›Full record

SynthesisCardiovascular diabetology2020

SGLT2 inhibitors and atrial fibrillation in type 2 diabetes: a systematic review with meta-analysis of 16 randomized controlled trials.

Wen-Jie Li, Xing-Qing Chen, Ling-Ling Xu, Yuan-Qing Li, Bi-Hui Luo

Registry-linked trialOpen access · goldAbstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Cardiovascular diabetology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04780438 (Dapagliflozin to Prevent Atrial Fibrillation Recurrence After Transcatheter Pulmonary Venous Isolation.), which is not on this map. Cited by 76 papers, 15 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
76citing papers in PubMed, 15 pooled it
16.9field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT04780438 early_phase1unknown statusnot on this mapstarted 2021, after this paper: background citation

Dapagliflozin to Prevent Atrial Fibrillation Recurrence After Transcatheter Pulmonary Venous Isolation.

TypeinterventionalSponsorG.Gennimatas General HospitalRan2021 to 2023Enrolled350ConditionsAtrial Fibrillation Recurrent, Pulmonary Venous Isolation, Catheter Ablation, Sodium-glucose Co-transporter 2 InhibitorsArmsDapagliflozin, Placebo
3 · Its place in the literature

Who cites it

76 citing papers in PubMed, 15 syntheses or guidelines pooled it, 164 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Pooled it
  5. Pooled it
  6. Guideline
  7. Guideline
  8. Pooled it
  9. Pooled it
  10. Pooled it
  11. Pooled it
  12. Pooled it
  13. Pooled it
  14. Pooled it
  15. Pooled it
  16. Trial
  17. Trial
  18. Trial
  19. Article
  20. Article

16 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors at 2 institutions in 1 country.

Wen-Jie LiNanshan School, Guangzhou Medical University, Jingxiu Road, Panyu District, Guangzhou, Guangdong, China.
Xing-Qing ChenDepartment of Cardiology, The First Affiliated Hospital of Guangzhou Medical University, 151 Yan Jiang Xi Road, Guangzhou District, Guangdong, China.
Ling-Ling XuDepartment of Cardiology, The First Affiliated Hospital of Guangzhou Medical University, 151 Yan Jiang Xi Road, Guangzhou District, Guangdong, China.
Yuan-Qing LiDepartment of Cardiology, The First Affiliated Hospital of Guangzhou Medical University, 151 Yan Jiang Xi Road, Guangzhou District, Guangdong, China.
Bi-Hui LuoDepartment of Cardiology, The First Affiliated Hospital of Guangzhou Medical University, 151 Yan Jiang Xi Road, Guangzhou District, Guangdong, China. 932067133@qq.com.
First Affiliated Hospital of Guangzhou Medical University · CNGuangzhou Medical University · CN

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundType 2 diabetes is closely related to an increased risk of atrial fibrillation (AF) and atrial flutter (AFL). Whether sodium-glucose cotransporter 2 (SGLT2) inhibitors can attenuate AF/AFL progression remains unclear.

methodsWe searched electronic databases (PubMed, Embase and ClinicalTrials.gov) from their inception to January 2020 for trials evaluating the AF outcomes of SGLT2 inhibitors in patients with type 2 diabetes. The data search and extraction were conducted with a standardized data form and any conflicts were resolved by consensus. Relative risks (RRs) with 95% confidence intervals (CIs) were used for binary variables, and the weighed mean differences (WMDs) with the standard deviation (SDs) were applied for continuous variables.

resultsWe included data from 16 identified trials consisting of 38,335 patients with type 2 diabetes. Incorporated data demonstrated that compared to placebo, SGLT2 inhibitors significantly reduced AF/AFL (RR: 0.76; 95% CI 0.65-0.90; p = 0.001) and all-cause mortality (RR: 0.91; 95% CI 0.83-0.99; p = 0.03). AF/AFL reductions were not modified by age, body weight, glycated haemoglobin (HbA1c), or systolic blood pressure (SBP) at baseline (all p-interactions > 0.3). SGLT2 inhibitors also significantly reduced heart failure events (RR: 0.73; 95% CI 0.64-0.84; p < 0.00001), HbA1c (WMD: - 0.62%; 95% CI - 0.89 to - 0.34; p < 0.00001), body weight (WMD: - 2.12 kg; 95% CI - 2.91 to - 1.34; p < 0.00001), SBP (WMD: - 3.34 mmHg; 95% CI - 4.12 to - 2.56; p < 0.00001), and diastolic blood pressure (DBP) (WMD: - 1.11 mmHg; 95% CI - 1.62 to - 0.60; p < 0.0001). Of note, cerebrovascular events and myocardial infarction did not increase in patients taking SGLT2 inhibitors.

conclusionSGLT2 inhibitors may confer a specific AF/AFL-reduction benefit in the susceptible type 2 diabetes population, regardless of age, body weight, HbA1c, and systolic blood pressure at baseline. Such an AF/AFL-reduction benefit may be partly attributed to pharmacological effects on reductions in HbA1c, body weight, blood pressure, and the occurrence of heart failure.

Indexed as

Atrial FibrillationAtrial FlutterBiomarkersBlood GlucoseDiabetes Mellitus, Type 2Glycated HemoglobinHumansRandomized Controlled Trials as TopicRisk AssessmentRisk FactorsSodium-Glucose Transporter 2 InhibitorsTreatment OutcomeBiomarkersBlood GlucoseGlycated Hemoglobinhemoglobin A1c protein, humanSodium-Glucose Transporter 2 InhibitorsAtrial fibrillationAtrial flutterMeta-analysisSodium-glucose cotransporter 2 inhibitorsType 2 diabetes

Identifiers

PMID32847602
PMCPMC7448518
OpenAlexW3080459529

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.