Impact of Sodium-Glucose Cotransporter 2 Inhibitor on Recurrence After Catheter Ablation for Atrial Fibrillation in Patients With or Without Metabolic Syndrome.

IF 2.6 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Journal of Cardiovascular Electrophysiology Pub Date : 2025-09-03 DOI:10.1111/jce.70073

Yang Xu, Zixu Zhao, Hui Xu, Chao Jiang, Xiao Wang, Zejun Yang, Wenyu Shao, Hang Guo, Liu He, Qi Guo, Caihua Sang, Deyong Long, Xin Du, Jianzeng Dong, Changsheng Ma

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引用次数: 0

Abstract

Aims: The impact of sodium-glucose cotransporter-2 inhibitors (SGLT2i) on atrial fibrillation (AF) recurrence after catheter ablation is still inconclusive. Besides, their efficacy on AF recurrence stratified by metabolic syndrome (MetS) status remains unknown.

Methods: Patients with AF undergoing initial catheter ablation between January 2017 and December 2023 from the China-AF Registry were included. Patients were 1:1 propensity score-matched by SGLT2i use at discharge and stratified by baseline MetS status. The main outcome was the AF recurrence after a 3-month blanking period.

Results: After propensity score matching, 573 patients in the SGLT2i group and 573 in the non-SGLT2i group were included in the study. During the 20.5 ± 13.7 months follow-ups, AF recurrence occurred in 100 patients (17.5%) in the SGLT2i group and 168 patients (29.3%) in the non-SGLT2i group. SGLT2i was associated with lower AF recurrence (17.5% vs. 29.3%; HR 0.59, 95% CI: 0.46-0.75, p < 0.001), with consistent benefits in MetS (HR 0.61, 95% CI: 0.39-0.75, p = 0.03) and non-MetS subgroups (HR 0.58, 95% CI: 0.43-0.78, p < 0.001, P_interaction = 0.841). The effect of SGLT2i on the AF recurrence also remained consistent across the body mass index (BMI) spectrum (P_interaction = 0.740).

Conclusion: SGLT2i was associated with a lower risk of AF recurrence after catheter ablation independently of MetS status or BMI spectrum.

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钠-葡萄糖共转运蛋白2抑制剂对伴有或不伴有代谢综合征的心房颤动导管消融后复发的影响

目的：钠-葡萄糖共转运蛋白-2抑制剂（SGLT2i）对房颤（AF）导管消融后复发的影响尚不明确。此外，它们对按代谢综合征（MetS）状态分层的房颤复发的疗效尚不清楚。方法：纳入2017年1月至2023年12月中国房颤登记中心的房颤初始导管消融患者。患者在出院时使用SGLT2i与倾向评分1:1匹配，并根据基线MetS状态分层。主要观察结果为3个月后房颤复发。结果：经倾向评分匹配后，573例SGLT2i组和573例非SGLT2i组纳入研究。在20.5±13.7个月的随访中，SGLT2i组有100例（17.5%）患者复发，非SGLT2i组有168例（29.3%）患者复发。SGLT2i与较低的房颤复发率相关（17.5% vs 29.3%; HR 0.59, 95% CI: 0.46-0.75， p交互作用= 0.841）。SGLT2i对房颤复发的影响在身体质量指数（BMI）谱上也保持一致（p - interaction = 0.740）。结论：SGLT2i与导管消融后房颤复发风险降低相关，与MetS状态或BMI谱无关。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Cardiovascular Electrophysiology 医学-心血管系统

CiteScore

5.20

自引率

14.80%

发文量

433

审稿时长

3-6 weeks

期刊介绍： Journal of Cardiovascular Electrophysiology (JCE) keeps its readership well informed of the latest developments in the study and management of arrhythmic disorders. Edited by Bradley P. Knight, M.D., and a distinguished international editorial board, JCE is the leading journal devoted to the study of the electrophysiology of the heart.