SGLT2 inhibitors reduce arrhythmias risk in patients with type 2 diabetes: BMC study

A new study published in the recent issue of BMC Cardiovascular Diabetology journal found that in individuals with type 2 diabetes who received an implantable cardioverter-defibrillator or cardiac resynchronization therapy defibrillator (ICD/CRT-D), empagliflozin lowers the number of ventricular arrhythmias when compared to placebo.

Sodium-glucose cotransporter 2 (SGLT2) inhibitors lower the incidence of hospitalization for cardiovascular mortality and heart failure in people with type 2 diabetes, although their effect on arrhythmias is unclear. Fujiki and colleagues undertook this study to explore the impact of empagliflozin on ventricular arrhythmias in type 2 diabetic patients.

This comprehensive research was carried out for 24 weeks and included 150 patients with type 2 diabetes who were treated with an implanted cardioverter-defibrillator or cardiac resynchronization therapy defibrillator were randomly assigned to receive once-daily empagliflozin or a placebo. The primary outcome was the change in the number of ventricular arrhythmias from the previous 24 weeks of therapy. The secondary endpoints included changes in the number of suitable device discharges and other parameters.

The key findings of this study were;

The number of ventricular arrhythmias detected by ICD/CRT-D dropped by 1.69 in the empagliflozin group when compared to prior therapy, while it rose by 1.79 in the placebo group.

The coefficient for the between-group difference was -1.07 (95% confidence interval [CI] -1.29 to -0.86, P < 0.001).

The difference in the number of suitable device discharges during and before treatment was 0.06 in the empagliflozin group and 0.27 in the placebo group, with no significant difference between the groups (P = 0.204).

The findings suggest that Empagliflozin increase blood ketones and hematocrit while decreasing blood brain natriuretic peptide and total body weight.

The outcomes of this study highlights the role of Empagliflozin in reducing the occurrence of ventricular arrhythmias in type 2 diabetics who undergo implantable cardioverter-defibrillator or cardiac resynchronization therapy defibrillator treatment.

Overall, these findings illuminate the importance of considering SGLT2 inhibitors for their glucose-lowering effects and also for their potential to reduce arrhythmias and improve overall cardiovascular health in patients with type 2 diabetes. This could lead to more customized and effective treatment strategies in improving patient outcomes and quality of life.

Source:

Fujiki, S., Iijima, K., Nakagawa, Y., Takahashi, K., Okabe, M., Kusano, K., Owada, S., Kondo, Y., Tsujita, K., Shimizu, W., Tomita, H., Watanabe, M., Shoda, M., Watanabe, M., Tokano, T., Murohara, T., Kaneshiro, T., Kato, T., … Hayashi, H. (2024). Effect of empagliflozin on ventricular arrhythmias in patients with type 2 diabetes treated with an implantable cardioverter-defibrillator: the EMPA-ICD trial. In Cardiovascular Diabetology (Vol. 23, Issue 1). Springer Science and Business Media LLC. https://doi.org/10.1186/s12933-024-02309-9