Metformin Is Associated With a Lower Risk of Atrial Fibrillation and Ventricular Arrhythmias Compared With Sulfonylureas: An Observational Study.
Metformin Is Associated With a Lower Risk of Atrial Fibrillation and Ventricular Arrhythmias Compared With Sulfonylureas: An Observational Study.
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与磺脲类药物相比，二甲双胍与房颤和室性心律失常的风险较低相关：一项观察性研究。
DOI：
10.1161/circep.120.009115
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发表时间：
2021-03
期刊：
影响因子：
--
通讯作者：
Morrow JP
中科院分区：
文献类型：
--
作者：
Ostropolets A;Elias PA;Reyes MV;Wan EY;Pajvani UB;Hripcsak G;Morrow JP
2型糖尿病（DM2）是全世界最常见的慢性疾病之一，也是心血管疾病的重要原因。调查服用不同口服糖尿病药物的糖尿病患者发生房性和室性心律失常风险的研究很少。我们使用 IBM MarketScan® Medicare 补充数据库，通过倾向评分匹配来检查服用不同口服糖尿病药物的患者发生心律失常的风险。我们发现，与 DPP4 或 TZD 药物单药治疗相比，接受二甲双胍单药治疗的患者发生房性心律失常（包括心房颤动）的风险显着降低。与磺脲类单药治疗相比，二甲双胍单药治疗的患者房性心律失常、室性心律失常和心动过缓的风险显着降低。与其他一些组合相比，磺酰脲类和二甲双胍的联合治疗会增加房性心律失常的风险。不同的口服糖尿病药物具有显着不同的长期心律失常风险。具体而言，与磺脲类药物相比，二甲双胍可降低心房颤动和室性心律失常的风险。
Type 2 diabetes (DM2) is one of the most common chronic disorders worldwide and is an important cause of cardiovascular disease. Studies investigating the risk of atrial and ventricular arrhythmias in diabetic patients taking different oral diabetes medications are sparse. We used IBM MarketScan® Medicare Supplemental Database to examine the risk of arrhythmias for patients on different oral diabetes medications by propensity score matching. We found that patients on metformin monotherapy had significantly reduced risk of atrial arrhythmias, including atrial fibrillation, compared to monotherapy with DPP4 or TZD medications. Patients on metformin monotherapy had significantly reduced risk of atrial arrhythmias, ventricular arrhythmias, and bradycardia compared to monotherapy with sulfonylureas. Combination therapy with sulfonylureas and metformin had an increased risk of atrial arrhythmias compared to some other combinations. Different oral diabetes medications have significantly different long-term risk of arrhythmia. Specifically, metformin is associated with reduced risk of atrial fibrillation and ventricular arrhythmias compared to sulfonylureas.