Journal of general internal medicine

Glucagon-like peptide-1 drugs and the risk of irregular heartbeat in adults with diabetes: a real-world study

Updated

Abstract

In a matched cohort of 14,566 pairs, GLP-1 receptor agonist use was associated with a lower risk of atrial fibrillation compared to dipeptidyl peptidase-4 inhibitors.

  • GLP-1 receptor agonists were linked to an incidence rate difference of -1.0 per 1000 person-years for atrial fibrillation when compared to DPP4 inhibitors.
  • The hazard ratio for atrial fibrillation in patients using GLP-1 receptor agonists versus DPP4 inhibitors was 0.82, indicating a reduced risk.
  • In a separate cohort of 9,424 pairs, there was no significant difference in atrial fibrillation risk between GLP-1 receptor agonists and sodium-glucose cotransporter 2 inhibitors.
  • The incidence rate difference for atrial fibrillation when comparing GLP-1RA to SGLT2i was 0.4 per 1000 person-years, with a hazard ratio of 1.12.

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Funding

Competing interests

A. Chang reports having consultancy agreements with Amgen, Novartis, and Reata; reports receiving research funding from a Novo Nordisk Investigator Sponsored Study; reports having an advisory or leadership role with Reata, Relypsa; and reports having other interests or relationships with National Kidney Foundation grant support and the NKF Patient Network. E. Selvin reports receiving research support from the Foundation for the National Institutes of Health and the National Institutes of Health; reports receiving royalty payments from Wolters Kluwer for chapters and laboratory monographs in UpToDate on measurements of glycemic control and screening tests for type 2 diabetes; and reports having an advisory or leadership role with Diabetes Care and Diabetologia Editorial Board, the American Diabetes Association, and the American Heart Association. L. Inker reports having consultancy agreements with Diamtrix; reports receiving research funding to the institution for research and contracts with the National Institutes of Health, National Kidney Foundation, Omeros, Reata Pharmaceuticals; reports having consulting agreements to her institution with Omeros and Tricida Inc.; reports having an advisory or leadership role with the Alport Syndrome Foundation; and reports having other interests or relationships as a member of the American Society of Nephrology, the National Kidney Disease Education Program, and the National Kidney Foundation. M. Grams reports having an advisory or leadership role with AJKD, CJASN, JASN Editorial Board, KDIGO Executive Committee, NKF Scientific Advisory Board, and the USRDS Scientific Advisory Board; and reports having other interests or relationships with grant funding from NKF, which receives funding from multiple pharmaceutical companies, and grant funding from the National Institutes of Health. J. Shin reports receiving research funding from Merck and the National Institutes of Health. The remaining authors have nothing to disclose.
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