Sodium-glucose cotransporter 2 (SGLT2) inhibitors have well-documented effects on reducing hospitalization for heart failure and cardiovascular mortality, although the effect on atrial fibrillation (AF) has not been comprehensively investigated. Therefore, we performed a meta-analysis to assess the association between SGLT2 inhibitors and AF risk by systematically searching PubMed, Embase, and ClinicalTrials.gov. Two investigators independently identified randomized controlled trials, which compared SGLT2 inhibitors with control in patients with type 2 diabetes, heart failure, or chronic kidney disease. Primary outcomes were incident AF and stroke. We included 20 randomized trials involving 63,604 patients. The SGLT2 inhibitors used were dapagliflozin (7 studies, 28,834 patients), canagliflozin (7 studies, 17,440 patients), empagliflozin (5 studies, 9082 patients), and ertugliflozin (1 study, 8246 patients). Follow-up ranged from 24 weeks to 202 weeks. SGLT2 inhibitors treatment was associated with a significant attenuation in the risk of incident AF (odds ratio = 0.82; 95% confidence interval, 0.72–0.93; P = 0.002) compared with control. No significant difference in stroke between SGLT2 inhibitors and control groups was found (odds ratio = 0.99; 95% confidence interval, 0.85–1.15; P = 0.908). This present meta-analysis indicates that SGLT2 inhibitors are associated with a lower risk of incident AF and do not significantly affect stroke risk for patients with and without type 2 diabetes.

钠-葡萄糖协同转运蛋白 2 (SGLT2) 抑制剂在减少心力衰竭住院率和心血管死亡率方面具有良好的效果，但其对心房颤动 (AF) 的影响尚未得到全面研究。因此，我们通过系统地搜索 PubMed、Embase 和ClinicalTrials.gov进行荟萃分析，以评估 SGLT2 抑制剂与 AF 风险之间的关联。两名研究人员独立确定了随机对照试验，将 SGLT2 抑制剂与对照药物在 2 型糖尿病、心力衰竭或慢性肾病患者中进行比较。主要结局是房颤事件和中风。我们纳入了 20 项随机试验，涉及 63,604 名患者。使用的SGLT2抑制剂是达格列净（7项研究，28,834名患者）、卡格列净（7项研究，17,440名患者）、恩格列净（5项研究，9082名患者）和ertugliflozin（1项研究，8246名患者）。随访时间为 24 周至 202 周。与对照组相比，SGLT2 抑制剂治疗与 AF 风险显着降低相关（比值比 = 0.82；95% 置信区间，0.72–0.93；P = 0.002）。SGLT2抑制剂和对照组之间的卒中没有发现显着差异（比值比 = 0.99；95% 置信区间，0.85–1.15；P = 0.908）。本荟萃分析表明，SGLT2 抑制剂与较低的 AF 风险相关，并且不会显着影响患有或不患有 2 型糖尿病的患者的中风风险。