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Association of Antihyperglycemic Therapy with Risk of Atrial Fibrillation and Stroke in Diabetic Patients

1
Diabetes, Nutrition and Metabolic Diseases, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iași, Romania
2
“Sf. Spiridon” Emergency Hospital, 700111 Iași, Romania
3
Internal Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iași, Romania
4
“George I.M. Georgescu” Cardiovascular Diseases Institute, Cardiology Department, 700503 Iași, Romania
*
Authors to whom correspondence should be addressed.
Medicina 2019, 55(9), 592; https://doi.org/10.3390/medicina55090592
Received: 30 June 2019 / Revised: 2 September 2019 / Accepted: 9 September 2019 / Published: 15 September 2019
(This article belongs to the Special Issue Stroke, Dementia and Atrial Fibrillation)
Type 2 diabetes mellitus (DM) is associated with an increased risk of cardiovascular disease (CVD). Atrial fibrillation (AF) and stroke are both forms of CVD that have major consequences in terms of disabilities and death among patients with diabetes; however, they are less present in the preoccupations of scientific researchers as a primary endpoint of clinical trials. Several publications have found DM to be associated with a higher risk for both AF and stroke; some of the main drugs used for glycemic control have been found to carry either increased, or decreased risks for AF or for stroke in DM patients. Given the risk for thromboembolic cerebrovascular events seen in AF patients, the question arises as to whether stroke and AF occurring with modified incidences in diabetic individuals under therapy with various classes of antihyperglycemic medications are interrelated and should be considered as a whole. At present, the medical literature lacks studies specifically designed to investigate a cause–effect relationship between the incidences of AF and stroke driven by different antidiabetic agents. In default of such proof, we reviewed the existing evidence correlating the major classes of glucose-controlling drugs with their associated risks for AF and stroke; however, supplementary proof is needed to explore a hypothetically causal relationship between these two, both of which display peculiar features in the setting of specific drug therapies for glycemic control. View Full-Text
Keywords: diabetes mellitus; atrial fibrillation; stroke; metformin; thiazolidinediones; GLP-1 receptor agonists; SGLT-2 inhibitors diabetes mellitus; atrial fibrillation; stroke; metformin; thiazolidinediones; GLP-1 receptor agonists; SGLT-2 inhibitors
MDPI and ACS Style

Lăcătușu, C.-M.; Grigorescu, E.-D.; Stătescu, C.; Sascău, R.A.; Onofriescu, A.; Mihai, B.-M. Association of Antihyperglycemic Therapy with Risk of Atrial Fibrillation and Stroke in Diabetic Patients. Medicina 2019, 55, 592.

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