Metformin and thiazolidinedione combo protects against occurrence of AF in diabetes patients

Metformin (MET) combination treatment (HR 1) and MET alone (HR 0.959, 95% CI 0.935-0.985) both markedly reduced the probability of AF in comparison to the non-medication group. 

Even after controlling for a number of variables, MET (HR 0.977, 95% CI 0.964-0.99) and thiazolidinedione (TZD; HR 0.926, 95% CI 0.898-0.956) were the two anti-diabetic medications that consistently shown a protective effect against the occurrence of AF. 

Moreover, compared to other medication combinations, this protective effect was more notable with MET and TZD combination treatment (HR 0.802, 95% CI 0.754-0.853). 

Regardless of age, sex, length, or the severity of the diabetes, the preventative impact of MET and TZD therapy against AF was constant in the subgroup analysis.

In conclusion, thiazolidinedione and metformin both exhibited a protective effect against the occurrence of AF, however the combination of MET & TZD was the most successful one, reducing the risk of AF incidence by 20%.

Reference: 

Kim, S., Park, S. Y., Kim, B., Min, C., Cho, W., Yon, D. K., Kim, J. Y., Han, K.-D., Rhee, E.-J., Lee, W.-Y., & Rhee, S. Y. (2023). Association between antidiabetic drugs and the incidence of atrial fibrillation in patients with type 2 diabetes: A nationwide cohort study in South Korea. In Diabetes Research and Clinical Practice (Vol. 198, p. 110626). Elsevier BV. https://doi.org/10.1016/j.diabres.2023.110626