Effect of glycated hemoglobin on the recurrence rate of paroxysmal atrial fibrillation in patients with type 2 diabetes mellitus who used different glucose-lowering agents

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Abstract

Objective. To evaluate the effects of glycated hemoglobin (HbA1c) levels during different glycemic control regimens on the occurrence of paroxysmal atrial fibrillation (AF) episodes in patients with concurrent type 2 diabetes mellitus (DM) (T2DM).

Subjects and methods. The randomized prospective open-label study involved 73 patients (41 males and 32 females; their mean age was 61.4±10.5 years) with paroxysmal AF and T2DM. According to the prescribed therapy, the patients were divided into groups: Group 1 included 39 patients who received combination therapy with dapagliflozin (at a dose of 10 mg/day) and metformin; Group 2 consisted of 34 patients who took sulfonyl urea agents and metformin. The groups were matched for the main clinical and laboratory parameters.

Results. At a HbA1c level of 6.5–7.0%, the patients had significantly less frequently episodes of AF in both groups compared to those having an HbA1c 7.0–7.5% (30.4% versus 77.8%). After treatment, episodes of AF were significantly less frequently seen in Group 1 than in Group 2 (33.3% versus 58.8%; р<0.05).

Conclusion. It is desirable to achieve target HbA1C values of 6.5–7.0% (in the absence of contraindications) in patients with paroxysmal AF concurrent with T2DM during sugar-lowering therapy. It is recommended that sugar-lowering agents, such as dapagliflozin, with an organ-protective potential, should be used.

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About the authors

G. A. Ignatenko

M.Gorky Donetsk National Medical University

Email: prikav@yandex.ru
ORCID iD: 0000-0003-0562-3509

Doctor of Medical Sciences, Professor

Donetsk People's Republic, Donetsk

А. E. Bagriy

M.Gorky Donetsk National Medical University

Email: prikav@yandex.ru
ORCID iD: 0000-0002-0295-3724

Doctor of Medical Sciences, Professor

Donetsk People's Republic, Donetsk

О. A. Prikolota

M.Gorky Donetsk National Medical University

Email: prikav@yandex.ru
ORCID iD: 0000-0002-2127-6925

Candidate of Medical Sciences

Donetsk People's Republic, Donetsk

A. V. Prikolota

M.Gorky Donetsk National Medical University

Email: prikav@yandex.ru
ORCID iD: 0000-0002-9128-2511

Candidate of Medical Sciences

Donetsk People's Republic, Donetsk

Е. S. Mikhailichenko

M.Gorky Donetsk National Medical University

Email: prikav@yandex.ru
ORCID iD: 0000-0001-8625-1406

Candidate of Medical Sciences

Donetsk People's Republic, Donetsk

I. A. Golodnikov

M.Gorky Donetsk National Medical University

Author for correspondence.
Email: prikav@yandex.ru
ORCID iD: 0000-0001-6866-037X
Donetsk People's Republic, Donetsk

O. N. Bagriy

Donetsk Regional Clinical Territorial Medical Association of Medicines

Email: prikav@yandex.ru
ORCID iD: 0000-0003-1712-2760
Donetsk People's Republic, Donetsk

K. A. Kotova

M.Gorky Donetsk National Medical University

Email: prikav@yandex.ru
ORCID iD: 0000-0002-1268-7722
Donetsk People's Republic, Donetsk

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Supplementary files

Supplementary Files
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1. JATS XML
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2. Fig. 1. Impact of glycemia control and the duration of DM on the risk of AF (adapted from Wangs A., 2019 [7])

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3. Fig. 2. Pathophysiology of DM and AP (adapted from Wangs A., 2019 [7])

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4. Fig. 3. Comparison of the effects of sugar-lowering therapy agents on the occurrence of AP (adapted from Wangs A., 2019 [7])

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5. Fig. 4. Comparison of the frequency of paroxysmal AP episodes in patients in relation to the level of HbA1C and performed sugar-lowering therapy.

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