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Effect of Dapagliflozin on the Outcome of Radiofrequency Catheter Ablation in Patients with Type 2 Diabetes Mellitus and Atrial Fibrillation

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Abstract

Introduction

Dapagliflozin, one of the sodium-glucose cotransporter-2 inhibitors, has been widely used for the treatment of type 2 diabetes mellitus (T2DM) and heart failure. In this study, we sought to determine the impact of dapagliflozin on the outcome of radiofrequency catheter ablation (RFCA) for patients with T2DM and atrial fibrillation (AF).

Methods

This retrospective study included patients who underwent AF ablation between January 2019 to February 2021 at the First Affiliated Hospital of Zhengzhou University. All patients had a history of T2DM and were divided into the dapagliflozin group (n = 79) and the control group (n = 247) according to whether the patients were treated with dapagliflozin after ablation. The definition of AF recurrence was documented atrial arrhythmias over 30 s after a 1-month blanking period. Cox regression models were used to analyze the risk of AF recurrence.

Results

Overall, 326 patients were analyzed (mean age, 63.7±10.0 years old; male, 58.9%; paroxysmal AF, 52.8%; recurrence rate, 40.8%). We found that hemoglobin A1c before ablation was higher in the dapagliflozin group than in the control group (7.7±1.4 vs. 7.3±1.2, P = 0.007). After a mean follow-up of 15.5±8.9 months, the dapagliflozin group had a lower recurrence rate than the control group (27.8% vs. 44.9%, P = 0.007). Treatment with dapagliflozin (HR 0.614, ±95%CI 0.387-0.974, P = 0.038) was associated with a lower risk of recurrence of atrial arrhythmias (ATa) after ablation in multivariable Cox regression models that adjusted for duration of AF, BMI, AF type, left atrial diameter (LAD), and eGFR. The Cox regression model that incorporated hemoglobin A1c and other antidiabetic agents also demonstrated a similar reduction in the risk of recurrent atrial arrhythmias with dapagliflozin treatment (HR 0.611, ±95% CI 0.379-0.985, P = 0.043).

Conclusions

In patients with T2DM, treatment with dapagliflozin appears to be independently associated with a significant reduction in the risk of recurrent atrial arrhythmias after RFCA.

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Data Availability Statement

The data supporting the findings of this study are available on request.

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Funding

This work was partly supported by the National Key Research and Development Program (2016YFC1301000), awarded to Dr. Jianzeng Dong, MD, PhD.

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Authors and Affiliations

  1. Department of Cardiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, Henan, China

    Fangyuan Luo, Liping Sun, Yuekun Zhang, Jiaju Li, Yingwei Chen & Jianzeng Dong

  2. Department of Cardiology, China-Japan Friendship Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 10029, China

    Zhe Wang

  3. Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, 100029, China

    Jianzeng Dong

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  1. Fangyuan Luo
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  2. Liping Sun
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  4. Yuekun Zhang
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Contributions

FYL: Designed the study and wrote the manuscript. LPS and ZW: Contributed to writing of the manuscript. YKZ and JJL: Participated in data analysis. YWC: Supervised the data acquisition, data analysis and interpretation. JZD: Verifed the data extraction and reviewed the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Jianzeng Dong.

Ethics declarations

Ethics Approval

This study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the Ethics Committee of the First Affiliated Hospital of Zhengzhou University (Date 2020-05-22 /No 2020-KY-166).

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Informed consent was obtained from all individual participants included in the study.

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Not applicable.

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The authors have no relevant financial or non-financial interests to disclose.

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Luo, F., Sun, L., Wang, Z. et al. Effect of Dapagliflozin on the Outcome of Radiofrequency Catheter Ablation in Patients with Type 2 Diabetes Mellitus and Atrial Fibrillation. Cardiovasc Drugs Ther 38, 91–98 (2024). https://doi.org/10.1007/s10557-022-07368-2

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