Aim: This meta-analysis aims to evaluate the effect of semaglutide, a glucagon-like peptide-1 receptor agonist (GLP-1 RAs), on new-onset atrial fibrillation (AF) in randomized clinical trials (RCTs).
Methods and results: Twenty-six RCTs involving 48,583 participants (of whom 25,879 on semaglutide) with 541 new onset AF were analyzed. Semaglutide treatment resulted in a 17% reduction in AF incidence compared to controls (OR 0.83, 95% CI 0.70-0.98, p = 0.03) with no heterogeneity (I² = 0%). The effect was more pronounced with the oral formulation, which reduced AF incidence by 52% (OR 0.48, 95% CI 0.24-0.95, p = 0.04), while studies with active comparators showed a 59% reduction in AF risk (OR 0.41, 95% CI 0.20-0.83, p = 0.01). In trials without Sodium-Glucose Co-Transporter 2 inhibitors (SGLT2i) concomitant therapy, there was a significant reduction of 21% in new-onset AF (OR 0.79, 95% CI, 0.63-0.99; p=0.04). Meta-regression revealed no influence of baseline covariates, including BMI and HbA1c. An additional meta-regression analysis evaluating the percentage of patients on SGLT2 inhibitors as a potential moderator revealed no statistically significant association (p= 0.336).
Conclusions: Treatment with semaglutide significantly reduces the incidence of new-onset AF. This effect appears more evident with the oral formulation and independent of baseline characteristics.
Keywords: Atrial Fibrillation (AF); Diabetes; GLP1-RA; Obesity; Semaglutide.
This study evaluates whether semaglutide can reduce the risk of developing atrial fibrillation (AF). By analyzing data from 26 randomized controlled trials involving about 49,000 participants, the findings highlight semaglutide's potential role in offering additional cardiovascular benefits beyond its established effects on weight loss and blood sugar control. Key Findings:Treatment with semaglutide reduced the risk of new-onset atrial fibrillation by 17%, with the strongest effects observed in its oral formulation.The reduction in AF risk was independent of patient characteristics such as age, body mass index, or blood sugar levels and was particularly significant in studies without other concurrent therapies like SGLT2 inhibitors.
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