{"doi":"10.3390/jcm12082814","title":"Cerebrovascular, Cognitive and Cardiac Benefits of SGLT2 Inhibitors Therapy in Patients with Atrial Fibrillation and Type 2 Diabetes Mellitus: Results from a Global Federated Health Network Analysis","abstract":"<jats:p>Background: Sodium-glucose co-transporter 2 inhibitors (SGLT2i) are effective anti-diabetic drugs improving cardiovascular outcomes in type 2 diabetes mellitus (T2DM) patients. This study investigated cardiovascular, cerebrovascular and cognitive outcomes of SGLT2i therapy in patients with atrial fibrillation (AF) and T2DM. Methods: Observational study using TriNetX, a global health research network of anonymised electronic medical records from real-world patients between January 2018 and December 2019. The network includes healthcare organisations globally but predominately in the United States. AF patients (ICD-10-CM code: I48) with T2DM were divided according to SGLT2i use or not, and balanced using propensity score matching (PSM). Patients were followed-up for 3-years. The primary endpoints were ischaemic stroke/transient ischemic attack (TIA), intracranial haemorrhage (ICH), and incident dementia. Secondary endpoints were incident heart failure and mortality. Results: We identified 89,356 AF patients with T2DM of which 5061 (5.7%) were taking a SGLT2i. After PSM, 5049 patients (mean age 66.7 ± 10.6 years; 28.9% female) were included in each group. At 3-years follow-up, the risk of ischaemic stroke/TIA was higher in patients not receiving SGLT2i (HR 1.12, 95% CI 1.01–1.24) and for ICH (HR 1.57, 95% CI 1.25–1.99) and incident dementia (HR 1.66, 95% CI 1.30–2.12). Incident heart failure (HR 1.50, 95% CI 1.34–1.68) and mortality (HR 1.77, 95% CI 1.58–1.99) risks were increased in AF patients not receiving SGLT2i. Conclusions: In our large ‘real world’ analysis of patients with concomitant AF and T2DM, SGLT2i reduced the risk of cerebrovascular events, incident dementia, heart failure and death.</jats:p>","journal":"Journal of Clinical Medicine","year":2023,"id":604511,"datarank":1.5327849990653868,"base_score":3.6375861597263857,"endowment":3.6375861597263857,"self_citation_contribution":0.5456379239589579,"citation_network_contribution":0.987147075106429,"self_endowment_contribution":0.5456379239589579,"citer_contribution":0.987147075106429,"corpus_percentile":null,"corpus_rank":null,"citation_count":37,"citer_count":34,"citers_with_citation_signal":29,"citers_with_endowment":29,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":null,"is_data_producer":false,"deposit_databanks":null,"is_oa":false,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":null,"fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":1551045,"name":"José Miguel Rivera-Caravaca","orcid":"0000-0003-0492-6241","position":1,"is_corresponding":false},{"id":1551046,"name":"Raquel López-Gálvez","orcid":null,"position":2,"is_corresponding":false},{"id":1551047,"name":"Stephanie L. Harrison","orcid":null,"position":3,"is_corresponding":false},{"id":1551048,"name":"Francisco Marín","orcid":"0000-0001-7246-7708","position":4,"is_corresponding":false},{"id":1551049,"name":"Paula Underhill","orcid":null,"position":5,"is_corresponding":false},{"id":518151,"name":"Eduard Shantsila","orcid":"0000-0002-2429-6980","position":6,"is_corresponding":false},{"id":1404234,"name":"Garry McDowell","orcid":"0000-0002-2880-5236","position":7,"is_corresponding":false},{"id":517934,"name":"Manlio Vinciguerra","orcid":"0000-0002-1768-3894","position":8,"is_corresponding":false},{"id":82441,"name":"Rhys Davies","orcid":null,"position":9,"is_corresponding":false},{"id":381565,"name":"Clarissa Giebel","orcid":"0000-0002-0746-0566","position":10,"is_corresponding":false},{"id":614667,"name":"Deirdre A. Lane","orcid":"0000-0002-5604-9378","position":11,"is_corresponding":false},{"id":27696,"name":"Gregory Y. H. Lip","orcid":"0000-0002-7566-1626","position":12,"is_corresponding":false},{"id":1551044,"name":"Riccardo Proietti","orcid":null,"position":0,"is_corresponding":false}],"reference_count":0,"raw_metadata":{"has_enrichment":true,"resolved":true,"title":"Cerebrovascular, Cognitive and Cardiac Benefits of SGLT2 Inhibitors Therapy in Patients with Atrial Fibrillation and Type 2 Diabetes Mellitus: Results from a Global Federated Health Network Analysis","abstract":"<jats:p>Background: Sodium-glucose co-transporter 2 inhibitors (SGLT2i) are effective anti-diabetic drugs improving cardiovascular outcomes in type 2 diabetes mellitus (T2DM) patients. This study investigated cardiovascular, cerebrovascular and cognitive outcomes of SGLT2i therapy in patients with atrial fibrillation (AF) and T2DM. Methods: Observational study using TriNetX, a global health research network of anonymised electronic medical records from real-world patients between January 2018 and December 2019. The network includes healthcare organisations globally but predominately in the United States. AF patients (ICD-10-CM code: I48) with T2DM were divided according to SGLT2i use or not, and balanced using propensity score matching (PSM). Patients were followed-up for 3-years. The primary endpoints were ischaemic stroke/transient ischemic attack (TIA), intracranial haemorrhage (ICH), and incident dementia. Secondary endpoints were incident heart failure and mortality. Results: We identified 89,356 AF patients with T2DM of which 5061 (5.7%) were taking a SGLT2i. After PSM, 5049 patients (mean age 66.7 ± 10.6 years; 28.9% female) were included in each group. At 3-years follow-up, the risk of ischaemic stroke/TIA was higher in patients not receiving SGLT2i (HR 1.12, 95% CI 1.01–1.24) and for ICH (HR 1.57, 95% CI 1.25–1.99) and incident dementia (HR 1.66, 95% CI 1.30–2.12). Incident heart failure (HR 1.50, 95% CI 1.34–1.68) and mortality (HR 1.77, 95% CI 1.58–1.99) risks were increased in AF patients not receiving SGLT2i. Conclusions: In our large ‘real world’ analysis of patients with concomitant AF and T2DM, SGLT2i reduced the risk of cerebrovascular events, incident dementia, heart failure and death.</jats:p>","is_dataset_classified":null,"base_score":3.6109179126442243,"endowment":3.6109179126442243,"datacite_reuse_total":0,"file_count":0,"downloads":0,"views":0,"has_version_chain":false,"is_dataset":false,"is_oa":false,"pmid":"37109151","pmcid":null,"openalex_id":"https://openalex.org/W4365146541","authors":[],"funders":[],"total_grants":0,"fwci":5.45,"citation_percentile":0.97043407,"influential_citations":0,"citation_trend":[{"year":2023,"count":4},{"year":2024,"count":11},{"year":2025,"count":18},{"year":2026,"count":3}],"oa_status":"gold","license":"cc-by","oa_locations":[{"url":"https://www.mdpi.com/2077-0383/12/8/2814/pdf?version=1681217245","host_type":"journal"},{"url":"https://www.mdpi.com/2077-0383/12/8/2814/pdf?version=1681217245","host_type":"publisher"},{"url":"https://www.mdpi.com/2077-0383/12/8/2814/pdf","host_type":"publisher"},{"url":"https://doi.org/10.3390/jcm12082814","host_type":"journal"},{"url":"https://pubmed.ncbi.nlm.nih.gov/37109151","host_type":"repository"},{"url":"https://www.ncbi.nlm.nih.gov/pmc/articles/10142574","host_type":"repository"},{"url":"https://orcid.org/0000-0003-0492-6241","host_type":"repository"},{"url":"https://dx.doi.org/10.3390/jcm12082814","host_type":"repository"},{"url":"https://pmc.ncbi.nlm.nih.gov/articles/PMC10142574/pdf/jcm-12-02814.pdf","host_type":"repository"},{"url":"https://researchonline.ljmu.ac.uk/id/eprint/20278/1/Cerebrovascular%2C%20Cognitive%20and%20Cardiac%20Benefits%20of%20SGLT2%20Inhibitors%20Therapy%20in%20Patients%20with%20Atrial%20Fibrillation.pdf","host_type":"repository"}],"fields_of_study":["Diabetes Treatment and Management","Bariatric Surgery and Outcomes","Atrial Fibrillation Management and Outcomes"],"mesh_terms":[],"keywords":["Medicine","Atrial fibrillation","Internal medicine","Dementia","Stroke (engine)","Diabetes mellitus","Heart failure","Clinical endpoint","Propensity score matching","Type 2 Diabetes Mellitus","Cardiology","Observational study","Type 2 diabetes","Randomized controlled trial","Disease"],"sdg_mappings":[{"sdg_number":0,"sdg_label":"Good health and well-being"}],"linked_datasets":[],"clinical_trials":[],"software_tools":[],"database_accessions":[],"source":"live","citation_network_status":"fetched"},"created_at":"2026-07-30T00:18:30.212876Z","pmid":null,"pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}