Is the Risk of Diabetes Lower in Patients With Atrial Fibrillation Treated With Direct Oral Anticoagulant Compared to Warfarin?

Frontiers in Cardiovascular Medicine

article

Xuyang Liu¹  Shenghui Feng²  Zhuohui Chen³  Yue Zhou⁴  Kang Yin⁵  Zhengbiao Xue⁵  Wengen Zhu³ 

[1] Department of Cardiology, Jinggangshan University;Queen Mary School, Medical Department, Nanchang University;Department of Cardiology, The First Affiliated Hospital of Sun Yat-sen University;State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University;Department of Critical Care Medicine, The First Affiliated Hospital of Gannan Medical University

关键词: atrial fibrillation;    non-vitamin K antagonist oral anticoagulants;    diabetes mellitus;    warfarin;    meta-analysis;   

DOI  :  10.3389/fcvm.2022.874795

学科分类：地球科学(综合)

来源: Frontiers

【 摘 要 】

Background The use of anticoagulants is an established strategy to prevent stroke, embolism, and cardiovascular mortality in patients with atrial fibrillation (AF), but its role in the prevention of incident diabetes is unclear. We aimed to investigate this question by using participant data from cohort studies. Methods We conducted a meta-analysis of participants to investigate the impact of direct oral anticoagulants (DOACs) on the risk of new-onset diabetes in AF patients. The collection of related data was performed in the PubMed and EMBASE databases until December 2021, including studies associated with evaluating the correlation between DOACs and incident diabetes. The hazard ratios (HRs) and 95% confidence intervals (CIs) were adjusted by the random-effects model with an inverse variance method. Results Two cohort studies with a total of 24,434 patients were included in this study (warfarin: n = 6,906; DOACs: n = 17,528). Compared with warfarin, the use of DOACs could reduce the incident diabetic risk in AF patients (HR = 0.75, 95%CI: 0.68–0.82). Investigations about the effects of three major classes of DOACs showed that the individual use of dabigatran (HR = 0.76, 95%CI: 0.64–0.90), rivaroxaban (HR = 0.74, 95%CI: 0.64–0.87), apixaban (HR = 0.74, 95%CI: 0.60–0.92) and the combined use of rivaroxaban and apixaban (HR = 0.74, 95%CI: 0.66–0.84) could reduce the risk of new-onset diabetes compared with warfarin. This risk reduction effect could be observed in both male and female groups (HR = 0.73, 95%CI: 0.64–0.84, P < 0.00001; HR = 0.82, 95%CI: 0.82–0.99, P = 0.04). Conclusions Treatment with DOACs compared with warfarin reduced the risk of new-onset diabetes in both male and female patients with AF.

【 授权许可】

CC BY