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Semaglutide and Atrial Fibrillation: a systematic review and meta-analysis
Session:
SESSÃO DE POSTERS 29 - FIBRILHAÇÃO AURICULAR: DA PREVENÇÃO À INTERVENÇÃO
Speaker:
Maria João Primo
Congress:
CPC 2025
Topic:
L. Cardiovascular Pharmacology
Theme:
31. Pharmacology and Pharmacotherapy
Subtheme:
31.1 Cardiovascular Pharmacotherapy
Session Type:
Cartazes
FP Number:
---
Authors:
Maria João Primo; Luísa Gomes Rocha; Gonçalo Ferraz Costa; Rita Bertão Ventura; Didier Martinez; Inês Brito e Cruz; Lino Gonçalves
Abstract
<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Aptos,sans-serif"><strong><span style="font-family:"Times New Roman",serif">Introduction</span></strong><span style="font-family:"Times New Roman",serif">: Semaglutide is a glucagon-like peptide-1 receptor agonist that has been highly recommended for glycemic control and weight reduction. Obesity can also increase the risk of developing atrial fibrillation (AF).</span></span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Aptos,sans-serif"><strong><span style="font-family:"Times New Roman",serif">Aims</span></strong><span style="font-family:"Times New Roman",serif">: To assess the association of semaglutide with cardiac arrhythmias, primarily AF.</span></span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Aptos,sans-serif"><strong><span style="font-family:"Times New Roman",serif">Methods</span></strong><span style="font-family:"Times New Roman",serif">: We performed a systematic searched Pubmed, Embase and Cochrane database, encompassing studies published between the 1<sup>st </sup>of January 2010 and October 2024, to identify semaglutide’s randomized controlled trials (RCTs) with or without diabetic patients that reported new-onset AF. A Mantel-Haenszel method and fixed and random-effects model were used to calculate the odds ratio (OR) and 95% confidence interval (CI).</span></span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Aptos,sans-serif"><strong><span style="font-family:"Times New Roman",serif">Results</span></strong><span style="font-family:"Times New Roman",serif">: 4 RCTs were included, 3 of them using subcutaneous semaglutide and 1 oral semaglutide. A total of 9116 patients were included, providing 215 new-onset AF. Our meta-analysis revealed a lower incidence of new-onset AF in semaglutide patients (pooled OR, 0.75; 95% CI 0.57, 0.98, P =0.03; I² = 32%). </span></span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Aptos,sans-serif"><span style="font-family:"Times New Roman",serif">The pooled analysis for subcutaneous semaglutide yielded an OR of 0.73 (95% CI: 0.55–0.96, P=0.02), indicating a significant reduction in the odds of new onset AF. Heterogeneity was low to moderate (</span><span style="font-family:"Times New Roman",serif">I²</span><span style="font-family:"Times New Roman",serif">=30%, P=0.24). In contrast, a single study evaluating oral semaglutide reported an OR of 5.02 (95% CI: 0.24–104.88), with wide confidence intervals and no statistical significance.</span></span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Aptos,sans-serif"><span style="font-family:"Times New Roman",serif">The pooled analysis of four studies regarding prevention of new-onset heart failure yielded an odds ratio (OR) of 0.57 (95% CI: 0.21–1.54). While this suggests a potential reduction in heart failure odds in the semaglutide group, the result is not statistically significant (P=0.27). Notably, there was substantial heterogeneity among the studies (I² =91%, P<0.00001), indicating considerable variability in the reported effect sizes. The analysis was conducted using a random effects model to account for this heterogeneity. The wide confidence interval and high heterogeneity highlight the need for further studies to clarify this association.</span></span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Aptos,sans-serif"><strong><span style="font-family:"Times New Roman",serif">Conclusion</span></strong><span style="font-family:"Times New Roman",serif">: Our study suggests that in patients with or without diabetes, semaglutide reduces the risk of new-onset atrial fibrillation. This analysis provides an additional cardiovascular benefit of this drug besides the major adverse cardiovascular events protection.</span></span></span></p>
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