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

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.