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

View Article: PubMed Central - PubMed

ABSTRACT

Background: Accumulating 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.

Methods: Electronic 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.

Results: Pooled 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).

Conclusions: This 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.

No MeSH data available.


Related in: MedlinePlus

Forest plot showing the association association between thiazolidinediones (TZDs) and atrial fibrillation (AF)
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Fig2: Forest plot showing the association association between thiazolidinediones (TZDs) and atrial fibrillation (AF)

Mentions: Of the seven studies, four [15–18] studies showed that TZDs use attenuated either the risk of new-onset or recurrent AF, whereas the other three [12–14] studies did not indicate a statistically significant difference. Overall, the pooled analysis of the seven included studies suggested that patients treated with TZDs have nearly 30% lower risk of AF compared with controls (OR =0.73, 95% CI = 0.62–0.87, p = 0.0003; Fig. 2). No significant heterogeneity between the individual studies was observed (P = 0.36, I2 = 9%).Fig. 2


Thiazolidinedione use and atrial fibrillation in diabetic patients: a meta-analysis
Forest plot showing the association association between thiazolidinediones (TZDs) and atrial fibrillation (AF)
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC5382449&req=5

Fig2: Forest plot showing the association association between thiazolidinediones (TZDs) and atrial fibrillation (AF)
Mentions: Of the seven studies, four [15–18] studies showed that TZDs use attenuated either the risk of new-onset or recurrent AF, whereas the other three [12–14] studies did not indicate a statistically significant difference. Overall, the pooled analysis of the seven included studies suggested that patients treated with TZDs have nearly 30% lower risk of AF compared with controls (OR =0.73, 95% CI = 0.62–0.87, p = 0.0003; Fig. 2). No significant heterogeneity between the individual studies was observed (P = 0.36, I2 = 9%).Fig. 2

View Article: PubMed Central - PubMed

ABSTRACT

Background: Accumulating 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.

Methods: Electronic 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.

Results: Pooled 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).

Conclusions: This 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.

No MeSH data available.


Related in: MedlinePlus