Dapagliflozin tied to significant reduction in ventricular repolarization parameters in CVD patients with glycemic control

New research revealed that Dapagliflozin exerts antihyperglycemic effects irrespective of the cardiovascular disease status and also reduces the risk of ventricular arrhythmia in Cardiovascular Disease patients. The study was published in the Journal of Diabetes and its Complications. 

The prevalence of diabetes has increased enormously in recent years. Diabetes has been recognized as a global pandemic, leading to the development of high-risk cardiovascular diseases (CVD). In people with diabetes mellitus (DM), dapagliflozin, a selective inhibitor of sodium-glucose cotransporter 2 (SGLT2i), is prescribed as it has antihyperglycemic effects as well as a strong correlation with a reduced risk of cardiovascular events. Recent literature has also suggested the antiarrhythmic effects of Dapagliflozin. But there is limited data on the effects of dapagliflozin on the effects of glycemic control provided by anti-diabetic drugs on electrocardiographic (ECG) parameters. Hence researchers conducted a study to understand the effects of Dapagliflozin on ventricular repolarization heterogeneity parameters in patients with type 2 DM. 

Nearly 140 patients with a known diagnosis of type 2 DM who were newly prescribed dapagliflozin in addition to standard anti-diabetic therapy were enrolled in the study. Based on their cardiovascular disease status, the patients were divided into two groups. The effect of dapagliflozin treatment on ventricular repolarization parameters (frontal plane QRST angle, Tp-e interval, Tp-e/QTc, QTc, and QTc dispersion) was investigated, and patient groups were compared before and after treatment.

Key findings: 

• Among 140 patients, 70 (50 %) had CVD, and 70 (50 %) did not have CVD.
• There were significant reductions in ventricular repolarization parameters over the study period in the CVD group with diabetes with Dapagliflozin treatment. 
• Mean fQRST angle, Tp-e interval, Tp-e/QTc, QTc, and QTc dispersion were significantly lower than baseline values at 6-month follow-up visits in the CVD group. 

Thus, the study found that dapagliflozin has positive cardioprotective effects in diabetic patients. It had made many positive alterations in the ventricular arrhythmia risk parameters in patients with CVD thus reducing the risk of ventricular arrhythmia. 

Further reading: The effect of dapagliflozin therapy on ventricular repolarization parameters in electrocardiography in patients with diabetic cardiovascular disease. https://doi.org/10.1016/j.jdiacomp.2023.108547