Electrocardiographic changes associated with SGLT2 inhibitors and non-SGLT2 inhibitors: A multi-center retrospective study
BackgroundSodium-glucose co-transporter 2 (SGLT2) inhibitors has been shown with cardiovascular benefit in type 2 diabetes mellitus (T2DM) patients. However, its osmotic diuresis still concern physicians who may look for possible electrolyte imbalance. We therefore aimed to investigate electrocardio...
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| Format: | Article |
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Frontiers Media S.A.
2022-09-01
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| Series: | Frontiers in Cardiovascular Medicine |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fcvm.2022.934193/full |
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| author | Victor Chien-Chia Wu Kai-Pin Chiu Chun-Li Wang Chiu-Yi Hsu Hui-Tzu Tu Yu-Tung Huang Chih-Hsiang Chang Chien-Hao Huang Chang-Fu Kuo Chang-Fu Kuo Shao-Wei Chen Shao-Wei Chen Pao-Hsien Chu Shang-Hung Chang Shang-Hung Chang Shang-Hung Chang |
| author_facet | Victor Chien-Chia Wu Kai-Pin Chiu Chun-Li Wang Chiu-Yi Hsu Hui-Tzu Tu Yu-Tung Huang Chih-Hsiang Chang Chien-Hao Huang Chang-Fu Kuo Chang-Fu Kuo Shao-Wei Chen Shao-Wei Chen Pao-Hsien Chu Shang-Hung Chang Shang-Hung Chang Shang-Hung Chang |
| author_sort | Victor Chien-Chia Wu |
| collection | DOAJ |
| description | BackgroundSodium-glucose co-transporter 2 (SGLT2) inhibitors has been shown with cardiovascular benefit in type 2 diabetes mellitus (T2DM) patients. However, its osmotic diuresis still concern physicians who may look for possible electrolyte imbalance. We therefore aimed to investigate electrocardiographic (ECG) changes associated with SGLT2 inhibitors.MethodsElectronic medical records from Chang Gung Research Database between January 1, 2001 and January 31, 2019 were searched for patients with ECG reports and patients on an oral hypoglycemic agent (OHA). We then separate these T2DM patients with EKG into those taking either SGLT2 inhibitors or non-SGLT2 inhibitors. We excluded patients with OHA use <28 days, age <18 years, baseline ECG QTc > 500 ms, and ECG showing atrial fibrillation or atrial flutter. Propensity score matching (PSM) was performed between groups by age, sex, comorbidities, and medications (including QT prolonging medications). Conditional logistic regression and Firth's logistic regression for rare events were employed to compare the difference between SGLT2 and non-SGLT2 inhibitor patients.ResultsAfter exclusion criteria and PSM, there remained 1,056 patients with ECG on SGLT2 inhibitors and 2,119 patients with ECG on non-SGLT2 inhibitors in the study. There were no differences in PR intervals, QT prolongations by Bazett's or Fridericia's formulas, new onset ST-T changes, new onset CRBBB or CLBBB, and ventricular arrhythmia between the group of patients on SGLT2 inhibitors and the group of patients on non-SGLT2 inhibitors. There were no differences between the two groups in terms of cardiovascular death and sudden cardiac death. In addition, there were no differences between the two groups in terms of electrolytes.ConclusionsCompared with T2DM patients on non-SGLT2 inhibitors, there were no differences in PR interval, QT interval, ST-T changes, bundle-branch block, or ventricular arrhythmia in the patients on SGLT2 inhibitors. There were no differences in cardiovascular mortality between these two groups. In addition, there were no electrolyte differences between groups. SGLT2 inhibitors appeared to be well-tolerated in terms of cardiovascular safety. |
| first_indexed | 2024-04-12T18:49:04Z |
| format | Article |
| id | doaj.art-5184280733794803a7bd924386d74c3f |
| institution | Directory Open Access Journal |
| issn | 2297-055X |
| language | English |
| last_indexed | 2024-04-12T18:49:04Z |
| publishDate | 2022-09-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Cardiovascular Medicine |
| spelling | doaj.art-5184280733794803a7bd924386d74c3f2022-12-22T03:20:31ZengFrontiers Media S.A.Frontiers in Cardiovascular Medicine2297-055X2022-09-01910.3389/fcvm.2022.934193934193Electrocardiographic changes associated with SGLT2 inhibitors and non-SGLT2 inhibitors: A multi-center retrospective studyVictor Chien-Chia Wu0Kai-Pin Chiu1Chun-Li Wang2Chiu-Yi Hsu3Hui-Tzu Tu4Yu-Tung Huang5Chih-Hsiang Chang6Chien-Hao Huang7Chang-Fu Kuo8Chang-Fu Kuo9Shao-Wei Chen10Shao-Wei Chen11Pao-Hsien Chu12Shang-Hung Chang13Shang-Hung Chang14Shang-Hung Chang15Division of Cardiology, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan, TaiwanDivision of Cardiology, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan, TaiwanDivision of Cardiology, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan, TaiwanCenter for Big Data Analytics and Statistics, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan, TaiwanCenter for Big Data Analytics and Statistics, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan, TaiwanCenter for Big Data Analytics and Statistics, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan, TaiwanDepartment of Nephrology, Kidney Research Center, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan, TaiwanDivision of Hepatology, Department of Gastroenterology and Hepatology, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan, TaiwanDivision of Rheumatology, Allergy and Immunology, Department of Internal Medicine, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan, TaiwanDivision of Rheumatology, Orthopaedics and Dermatology, School of Medicine, University of Nottingham, Nottingham, United KingdomCenter for Big Data Analytics and Statistics, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan, TaiwanDepartment of Cardiothoracic and Vascular Surgery, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan, TaiwanDivision of Cardiology, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan, TaiwanDivision of Cardiology, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan, TaiwanCenter for Big Data Analytics and Statistics, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan, TaiwanGraduate Institute of Nursing, Chang Gung University of Science and Technology, Taoyuan, TaiwanBackgroundSodium-glucose co-transporter 2 (SGLT2) inhibitors has been shown with cardiovascular benefit in type 2 diabetes mellitus (T2DM) patients. However, its osmotic diuresis still concern physicians who may look for possible electrolyte imbalance. We therefore aimed to investigate electrocardiographic (ECG) changes associated with SGLT2 inhibitors.MethodsElectronic medical records from Chang Gung Research Database between January 1, 2001 and January 31, 2019 were searched for patients with ECG reports and patients on an oral hypoglycemic agent (OHA). We then separate these T2DM patients with EKG into those taking either SGLT2 inhibitors or non-SGLT2 inhibitors. We excluded patients with OHA use <28 days, age <18 years, baseline ECG QTc > 500 ms, and ECG showing atrial fibrillation or atrial flutter. Propensity score matching (PSM) was performed between groups by age, sex, comorbidities, and medications (including QT prolonging medications). Conditional logistic regression and Firth's logistic regression for rare events were employed to compare the difference between SGLT2 and non-SGLT2 inhibitor patients.ResultsAfter exclusion criteria and PSM, there remained 1,056 patients with ECG on SGLT2 inhibitors and 2,119 patients with ECG on non-SGLT2 inhibitors in the study. There were no differences in PR intervals, QT prolongations by Bazett's or Fridericia's formulas, new onset ST-T changes, new onset CRBBB or CLBBB, and ventricular arrhythmia between the group of patients on SGLT2 inhibitors and the group of patients on non-SGLT2 inhibitors. There were no differences between the two groups in terms of cardiovascular death and sudden cardiac death. In addition, there were no differences between the two groups in terms of electrolytes.ConclusionsCompared with T2DM patients on non-SGLT2 inhibitors, there were no differences in PR interval, QT interval, ST-T changes, bundle-branch block, or ventricular arrhythmia in the patients on SGLT2 inhibitors. There were no differences in cardiovascular mortality between these two groups. In addition, there were no electrolyte differences between groups. SGLT2 inhibitors appeared to be well-tolerated in terms of cardiovascular safety.https://www.frontiersin.org/articles/10.3389/fcvm.2022.934193/fulltype 2 diabetes mellitussodium-glucose co-transporter 2 (SGLT 2) inhibitorselectrocardiogramQT prolongationoutcome |
| spellingShingle | Victor Chien-Chia Wu Kai-Pin Chiu Chun-Li Wang Chiu-Yi Hsu Hui-Tzu Tu Yu-Tung Huang Chih-Hsiang Chang Chien-Hao Huang Chang-Fu Kuo Chang-Fu Kuo Shao-Wei Chen Shao-Wei Chen Pao-Hsien Chu Shang-Hung Chang Shang-Hung Chang Shang-Hung Chang Electrocardiographic changes associated with SGLT2 inhibitors and non-SGLT2 inhibitors: A multi-center retrospective study Frontiers in Cardiovascular Medicine type 2 diabetes mellitus sodium-glucose co-transporter 2 (SGLT 2) inhibitors electrocardiogram QT prolongation outcome |
| title | Electrocardiographic changes associated with SGLT2 inhibitors and non-SGLT2 inhibitors: A multi-center retrospective study |
| title_full | Electrocardiographic changes associated with SGLT2 inhibitors and non-SGLT2 inhibitors: A multi-center retrospective study |
| title_fullStr | Electrocardiographic changes associated with SGLT2 inhibitors and non-SGLT2 inhibitors: A multi-center retrospective study |
| title_full_unstemmed | Electrocardiographic changes associated with SGLT2 inhibitors and non-SGLT2 inhibitors: A multi-center retrospective study |
| title_short | Electrocardiographic changes associated with SGLT2 inhibitors and non-SGLT2 inhibitors: A multi-center retrospective study |
| title_sort | electrocardiographic changes associated with sglt2 inhibitors and non sglt2 inhibitors a multi center retrospective study |
| topic | type 2 diabetes mellitus sodium-glucose co-transporter 2 (SGLT 2) inhibitors electrocardiogram QT prolongation outcome |
| url | https://www.frontiersin.org/articles/10.3389/fcvm.2022.934193/full |
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