Effect of antidiabetic drugs on the risk of atrial fibrillation: mechanistic insights from clinical evidence and translational studies

Ting-Wei Lee; Ting-I Lee; Yung-Kuo Lin; Yao-Chang Chen; Yu-Hsun Kao; Yi-Jen Chen

doi:10.1007/s00018-020-03648-y

Effect of antidiabetic drugs on the risk of atrial fibrillation: mechanistic insights from clinical evidence and translational studies

Cell Mol Life Sci. 2021 Feb;78(3):923-934. doi: 10.1007/s00018-020-03648-y. Epub 2020 Sep 23.

Authors

Ting-Wei Lee^{1

2}, Ting-I Lee^{1

2

3}, Yung-Kuo Lin^{4

5}, Yao-Chang Chen⁶, Yu-Hsun Kao^{7

8}, Yi-Jen Chen^{9

10

11}

Affiliations

¹ Division of Endocrinology and Metabolism, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.
² Division of Endocrinology and Metabolism, Department of Internal Medicine, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan.
³ Department of General Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.
⁴ Division of Cardiology, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.
⁵ Division of Cardiovascular Medicine, Department of Internal Medicine, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan.
⁶ Department of Biomedical Engineering, National Defense Medical Center, Taipei, Taiwan.
⁷ Graduate Institute of Clinical Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.
⁸ Department of Medical Education and Research, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan.
⁹ Graduate Institute of Clinical Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan. yjchen@tmu.edu.tw.
¹⁰ Cardiovascular Research Center, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan. yjchen@tmu.edu.tw.
¹¹ Taipei Heart Institute, Taipei Medical University, Taipei, Taiwan. yjchen@tmu.edu.tw.

PMID: 32965513
DOI: 10.1007/s00018-020-03648-y

Abstract

Diabetes mellitus (DM) is an independent risk factor for atrial fibrillation (AF), which is the most common sustained arrhythmia and is associated with substantial morbidity and mortality. Advanced glycation end product and its receptor activation, cardiac energy dysmetabolism, structural and electrical remodeling, and autonomic dysfunction are implicated in AF pathophysiology in diabetic hearts. Antidiabetic drugs have been demonstrated to possess therapeutic potential for AF. However, clinical investigations of AF in patients with DM have been scant and inconclusive. This article provides a comprehensive review of research findings on the association between DM and AF and critically analyzes the effect of different pharmacological classes of antidiabetic drugs on AF.

Keywords: DPP-4; GLP-1; Metformin; SGLT2; Thiazolidinedione.

Publication types

Review

MeSH terms

Atrial Fibrillation / etiology*
Atrial Fibrillation / metabolism
Diabetes Mellitus / drug therapy
Dipeptidyl-Peptidase IV Inhibitors / adverse effects
Dipeptidyl-Peptidase IV Inhibitors / therapeutic use
Glucagon-Like Peptide-1 Receptor / antagonists & inhibitors
Glucagon-Like Peptide-1 Receptor / metabolism
Glycation End Products, Advanced / metabolism
Humans
Hypoglycemic Agents / adverse effects*
Hypoglycemic Agents / therapeutic use
Receptor for Advanced Glycation End Products / metabolism
Risk Factors
Sodium-Glucose Transporter 2 Inhibitors / adverse effects
Sodium-Glucose Transporter 2 Inhibitors / therapeutic use

Substances

Dipeptidyl-Peptidase IV Inhibitors
Glucagon-Like Peptide-1 Receptor
Glycation End Products, Advanced
Hypoglycemic Agents
Receptor for Advanced Glycation End Products
Sodium-Glucose Transporter 2 Inhibitors

Abstract

Publication types

MeSH terms

Substances

Grants and funding