Dissecting the reduction in cardiovascular death with SGLT2 inhibitors: Potential contribution of effects on ventricular arrhythmias and sudden cardiac death?
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 (SG...
| Main Author: | |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2022-10-01
|
| Series: | Diabetes Epidemiology and Management |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2666970622000579 |
| _version_ | 1797991367783219200 |
|---|---|
| author | André J Scheen |
| author_facet | André J Scheen |
| author_sort | André J Scheen |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-04-11T08:51:14Z |
| format | Article |
| id | doaj.art-bb8419d634df4b06bfe527c9c8427648 |
| institution | Directory Open Access Journal |
| issn | 2666-9706 |
| language | English |
| last_indexed | 2024-04-11T08:51:14Z |
| publishDate | 2022-10-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Diabetes Epidemiology and Management |
| spelling | doaj.art-bb8419d634df4b06bfe527c9c84276482022-12-22T04:33:35ZengElsevierDiabetes Epidemiology and Management2666-97062022-10-018100107Dissecting the reduction in cardiovascular death with SGLT2 inhibitors: Potential contribution of effects on ventricular arrhythmias and sudden cardiac death?André J Scheen0Division of Clinical Pharmacology, Centre for Interdisciplinary Research on Medicines (CIRM), University of Liège, Liège, Belgium; Division of Diabetes, Nutrition and Metabolic Disorders, Department of Medicine, CHU Liège, Liège, Belgium; Corresponding author.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.http://www.sciencedirect.com/science/article/pii/S2666970622000579Cardiac arrhythmiaHeart failureSGLT2 inhibitorSudden cardiac deathType 2 diabetesVentricular fibrillation |
| spellingShingle | André J Scheen Dissecting the reduction in cardiovascular death with SGLT2 inhibitors: Potential contribution of effects on ventricular arrhythmias and sudden cardiac death? Diabetes Epidemiology and Management Cardiac arrhythmia Heart failure SGLT2 inhibitor Sudden cardiac death Type 2 diabetes Ventricular fibrillation |
| title | Dissecting the reduction in cardiovascular death with SGLT2 inhibitors: Potential contribution of effects on ventricular arrhythmias and sudden cardiac death? |
| title_full | Dissecting the reduction in cardiovascular death with SGLT2 inhibitors: Potential contribution of effects on ventricular arrhythmias and sudden cardiac death? |
| title_fullStr | Dissecting the reduction in cardiovascular death with SGLT2 inhibitors: Potential contribution of effects on ventricular arrhythmias and sudden cardiac death? |
| title_full_unstemmed | Dissecting the reduction in cardiovascular death with SGLT2 inhibitors: Potential contribution of effects on ventricular arrhythmias and sudden cardiac death? |
| title_short | Dissecting the reduction in cardiovascular death with SGLT2 inhibitors: Potential contribution of effects on ventricular arrhythmias and sudden cardiac death? |
| title_sort | dissecting the reduction in cardiovascular death with sglt2 inhibitors potential contribution of effects on ventricular arrhythmias and sudden cardiac death |
| topic | Cardiac arrhythmia Heart failure SGLT2 inhibitor Sudden cardiac death Type 2 diabetes Ventricular fibrillation |
| url | http://www.sciencedirect.com/science/article/pii/S2666970622000579 |
| work_keys_str_mv | AT andrejscheen dissectingthereductionincardiovasculardeathwithsglt2inhibitorspotentialcontributionofeffectsonventriculararrhythmiasandsuddencardiacdeath |