Observational studyCardiovascular diabetology2017
Dipeptidyl peptidase-4 inhibitor decreases the risk of atrial fibrillation in patients with type 2 diabetes: a nationwide cohort study in Taiwan.
Observational study in Cardiovascular diabetology, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 39 papers, 2 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
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Who cites it
39 citing papers in PubMed, 2 syntheses or guidelines pooled it, 78 citations in OpenAlex.
- Network and Pairwise Meta-Analysis of the Association Between Novel Hypoglycemic Agents and Atrial Fibrillation Risk in Patients With Type 2 Diabetes Mellitus.Diabetes/metabolism research and reviews · 2026Pooled it
- Sodium glucose co-transporter 2 (SGLT2) inhibitors versus dipeptidyl peptidase-4 (DPP-4) inhibitors and the risk of Atrial Fibrillation in patients with type 2 diabetes mellitus: a meta-analysis.BMC cardiovascular disorders · 2025Pooled it
- Modifiable Risk Factors in Atrial Fibrillation: Clinical Implications and Pathophysiological Insights.Annals of noninvasive electrocardiology : the official journal of the International Society for Holter and Noninvasive Electrocardiology, Inc · 2026Review
- Comparative effects of second-line oral antidiabetic medications on atrial fibrillation risk in patients with type 2 diabetes: a nationwide retrospective cohort study.Cardiovascular diabetology · 2026Article
- A multimodal vision knowledge graph of cardiovascular disease.Nature cardiovascular research · 2026Article
- Complex interrelationship and therapeutic advances in diabetic patients with atrial fibrillation.World journal of cardiology · 2025Review
- Diabetes Mellitus and Atrial Fibrillation: Mechanistic Insights and Therapeutic Impacts of Glucose-Lowering Drugs.Life (Basel, Switzerland) · 2025Review
- Review
- Insulin resistance, left atrial anatomical remodeling, and recurrence in patients with atrial fibrillation undergoing radiofrequency ablation.European journal of medical research · 2025Article
- Atrial APD prolongation caused by the upregulation of RAGE and subsequentActa biochimica et biophysica Sinica · 2025Article
- The Role of Early Risk Factor Modification and Ablation in Atrial Fibrillation Substrate Remodeling Prevention.Biomedicines · 2025Review
- Mechanisms of beneficial effects of DPP-4 inhibitors as a promising perspective for the prevention/treatment of the disruption of cardio-cerebrovascular homeostasis.Frontiers in pharmacology · 2025Review
- Mitochondrial Dysfunction in Atrial Fibrillation: The Need for a Strong Pharmacological Approach.Biomedicines · 2024Review
- The effect of non-insulin-based insulin resistance indices on the prediction of recurrence in patients with atrial fibrillation undergoing radiofrequency catheter ablation.Cardiovascular diabetology · 2024Article
- Effect of different hypoglycemic drugs and insulin on the risk of new-onset atrial fibrillation in people with diabetes: a network meta-analysis.European journal of medical research · 2024Article
- Lower Atrial Fibrillation Risk With Sodium-Glucose Cotransporter 2 Inhibitors Than With Dipeptidyl Peptidase-4 Inhibitors in Individuals With Type 2 Diabetes: A Nationwide Cohort Study.Korean circulation journal · 2024Article
- Epidemiology and modifiable risk factors for atrial fibrillation.Nature reviews. Cardiology · 2023Review
- Article
- Atrial fibrillation and coronary artery disease: An integrative review focusing on therapeutic implications of this relationship.World journal of cardiology · 2023Review
- Diabetes mellitus and atrial fibrillation-from pathophysiology to treatment.World journal of diabetes · 2023Review
Corrections and comments
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Authors and funding
10 authors at 2 institutions in 1 country.
Funding
Abstract
backgroundWhether dipeptidyl peptidase-4 inhibitor (DPP4i) is associated with a lower risk of new-onset atrial fibrillation (AF) in patients with diabetes remains unclear. This study aimed to evaluate the risk of AF associated with use of DPP4i among a longitudinal cohort of patients with diabetes.
methodsOver a 3-year period, 480,000 patients with diabetes were analyzed utilizing Taiwan's National Health Insurance Research Database and 90,880 patients taking metformin as first-line therapy were enrolled. Patients were further divided into two groups: (1) DPP4i users: those taking DPP4i and (2) non-DPP4i users: those prescribed other hypoglycemic agents (HAs) as second-line drug. Study end point was defined by diagnosis of AF, addition of any third-line HA, or the end of the study period (December 31, 2013), whichever came first.
resultsA total of 16,017 DPP4i users and 74,863 non-DPP4i users were eligible for the study. For the DPP4i group, most patients were prescribed sitagliptin (n = 12,180; 76%). Among the non-DPP4i group, most patients took sulfonylurea (n = 60,606; 81%) as their second-line medication. DPP4i users were associated with a lower risk of new-onset AF compared with non-DPP4i users after propensity-score weighting (hazard ratio 0.65; P < 0.0001). Subgroup analysis showed that DPP4i user were associated with a lower risk of new-onset AF compared with non-DPP4i users in most subgroups. Multivariate analysis indicated that use of DPP4i was associated with lower risk of new-onset AF and age > 65 years, presence of hypertension, and ischemic heart disease were independent risk factors for new-onset AF.
conclusionsAmong patients with diabetes prescribed with metformin, the patients with DPP4i as second HA were associated with a lower risk of AF compared with the patients with other drugs as second HAs in real-world practice.
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