Thiazolidinedione use and atrial fibrillation in diabetic patients: a meta-analysis

BMC Cardiovascular Disorders

Research Article

Gary Tse¹  Panagiotis Korantzopoulos²  Konstantinos P. Letsas³  Mengqi Gong⁴  Xiaowei Zhang⁴  Lei Meng⁴  Tong Liu⁴  Zhiwei Zhang⁴  Guangping Li⁴ 

[1] Department of Medicine and Therapeutics, Faculty of Medicine, Chinese University of Hong Kong, Hong Kong, SAR, People’s Republic of China;Li KaShing Institute of Health Sciences, Faculty of Medicine, Chinese University of Hong Kong, Hong Kong, SAR, People’s Republic of China;First Department of Cardiology, University of Ioannina Medical School, Ioannina, Greece;Second Department of Cardiology, Laboratory of Cardiac Electrophysiology, “Evangelismos” General Hospital of Athens, Athens, Greece;Tianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular Disease, Department of Cardiology, Tianjin Institute of Cardiology, Second Hospital of Tianjin Medical University, No. 23 Pingjiang Road, Hexi District, 300211, Tianjin, People’s Republic of China;

关键词: Atrial fibrillation;    Diabetes mellitus;    Thiazolidinediones;    Pioglitazone;    Rosiglitazone;    Meta-analysis;   

DOI  :  10.1186/s12872-017-0531-4

 received in 2016-10-28, accepted in 2017-04-01,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundAccumulating evidence suggests that thiazolidinediones (TZDs) may exert protective effects in atrial fibrillation (AF). The present meta-analysis investigated the association between TZD use and the incidence of AF in diabetic patients.MethodsElectronic databases were searched until December 2016. Of the 346 initially identified records, 3 randomized clinical trials (RCTs) and 4 observational studies with 130,854 diabetic patients were included in the final analysis.ResultsPooled analysis of the included studies demonstrated that patients treated with TZDs had approximately 30% lower risk of developing AF compared to controls [odds ratio (OR): 0.73, 95% confidence interval (CI): 0.62 to 0.87, p = 0.0003]. This association was consistently observed for both new onset AF (OR =0.77, p = 0.002) and recurrent AF (OR =0.41, p = 0.002), pioglitazone use (OR =0.56, p = 0.04) but not rosiglitazone use (OR =0.78, p = 0.12). The association between TZD use and AF incidence was not significant in the pooled analysis of three RCTs (OR =0.77, 95% CI = 0.53–1.12, p = 0.17), but was significantly in the pooled analysis of the four observational studies (OR =0.71, p = 0.0003).ConclusionsThis meta-analysis suggests that TZDs may confer protection against AF in the setting of diabetes mellitus (DM). This class of drugs can be used as upstream therapy for DM patients to prevent the development of AF. Further large-scale RCTs are needed to determine whether TZDs use could prevent AF in the setting of DM.

【 授权许可】

CC BY   
© The Author(s). 2017