Scholarlink

Background <p>GLP1 receptor agonists (GLP-1 RAs) improve cardiorenal outcomes in chronic kidney disease (CKD) patients with obesity or type 2 diabetes. Whether GLP-1 RAs reduce risk of atrial fibrillation (AF) in CKD patients, especially in absence of diabetes or obesity, is unclear.</p> Objective <p>Investigate association between GLP-1 RA use and AF in patients with CKD.</p> Methods <p>Using the TriNetX US Collaborative Network, we identified patients with CKD without prior AF or kidney failure. First use of GLP-1 RA (exposure) served as index event. For non-users, an outpatient visit after chronic kidney disease diagnosis served as pseudo-index event. After 1:1 propensity score matching of users to non-users for baseline risk factors, the cohort was followed up from index/pseudo-index event up to 3 years, death, or end of study period. Primary outcome was incident AF; secondary outcomes were AF-related interventions (a composite of ablation therapy, left atrial appendage occlusion, cardioversion, or pacemaker implantation), heart failure exacerbation, use of antiarrhythmic therapy, major adverse cardiovascular events, kidney failure, major adverse kidney events, and death. Survival analyses were performed.</p> Results <p>After propensity score matching, each cohort—GLP-1 RA and non-GLP-1 RA—had 37,768 patients with CKD without prior AF or kidney failure. Mean age was 67 ± 11 years; 55% female; 21% Black; 63% diabetic; mean body mass index, 34 ± 7&#xa0;kg/m<sup>2</sup>; and mean eGFR, 49 ± 20 mL/min/1.73&#xa0;m². GLP-1 RA cohort developed fewer atrial fibrillation (6.9%) than non-GLP-1 RA cohort (12.4%) with HR 0.59, 95% CI 0.56–0.62. Associations remained consistent in non-obese (HR 0.63, 95% CI 0.57–0.70), non-diabetic (HR 0.42, 95% CI 0.36–0.49), and non-diabetic + non-obese (HR 0.59, 95% CI 0.46–0.77) subgroups. Use of GLP-1 RA was also associated with lower risk of composite AF-related interventions (HR 0.58, 95% CI 0.55–0.61), heart failure exacerbation (HR 0.48, 95% CI 0.46–0.49), antiarrhythmic therapy (HR 0.6, 95% CI 0.56–0.65), major adverse cardiovascular events (HR 0.58, 95% CI 0.56–0.59), progression to kidney failure (HR 0.70, 95% CI 0.66–0.74), major adverse kidney events (HR 0.55, 95% CI 0.53–0.56), and death (HR 0.52; 95% CI, 0.49–0.55).</p> Conclusion <p>In this retrospective cohort, use of GLP-1 RAs was associated with lower risk of AF in non-dialysis CKD patients, even those without diabetes or obesity.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

GLP-1 Agonists and Risk of Atrial Fibrillation in Non-Dialysis Chronic Kidney Disease

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2026年7月3日

查看全文
  • Parth Dhamelia,
  • Ninad Khandekar,
  • Srikanth Vallurupalli,
  • Jorge Saucedo,
  • John Arthur,
  • Dharmik Jadvani,
  • Vikram Beemidi,
  • Nishank Jain

摘要

Background

GLP1 receptor agonists (GLP-1 RAs) improve cardiorenal outcomes in chronic kidney disease (CKD) patients with obesity or type 2 diabetes. Whether GLP-1 RAs reduce risk of atrial fibrillation (AF) in CKD patients, especially in absence of diabetes or obesity, is unclear.

Objective

Investigate association between GLP-1 RA use and AF in patients with CKD.

Methods

Using the TriNetX US Collaborative Network, we identified patients with CKD without prior AF or kidney failure. First use of GLP-1 RA (exposure) served as index event. For non-users, an outpatient visit after chronic kidney disease diagnosis served as pseudo-index event. After 1:1 propensity score matching of users to non-users for baseline risk factors, the cohort was followed up from index/pseudo-index event up to 3 years, death, or end of study period. Primary outcome was incident AF; secondary outcomes were AF-related interventions (a composite of ablation therapy, left atrial appendage occlusion, cardioversion, or pacemaker implantation), heart failure exacerbation, use of antiarrhythmic therapy, major adverse cardiovascular events, kidney failure, major adverse kidney events, and death. Survival analyses were performed.

Results

After propensity score matching, each cohort—GLP-1 RA and non-GLP-1 RA—had 37,768 patients with CKD without prior AF or kidney failure. Mean age was 67 ± 11 years; 55% female; 21% Black; 63% diabetic; mean body mass index, 34 ± 7 kg/m2; and mean eGFR, 49 ± 20 mL/min/1.73 m². GLP-1 RA cohort developed fewer atrial fibrillation (6.9%) than non-GLP-1 RA cohort (12.4%) with HR 0.59, 95% CI 0.56–0.62. Associations remained consistent in non-obese (HR 0.63, 95% CI 0.57–0.70), non-diabetic (HR 0.42, 95% CI 0.36–0.49), and non-diabetic + non-obese (HR 0.59, 95% CI 0.46–0.77) subgroups. Use of GLP-1 RA was also associated with lower risk of composite AF-related interventions (HR 0.58, 95% CI 0.55–0.61), heart failure exacerbation (HR 0.48, 95% CI 0.46–0.49), antiarrhythmic therapy (HR 0.6, 95% CI 0.56–0.65), major adverse cardiovascular events (HR 0.58, 95% CI 0.56–0.59), progression to kidney failure (HR 0.70, 95% CI 0.66–0.74), major adverse kidney events (HR 0.55, 95% CI 0.53–0.56), and death (HR 0.52; 95% CI, 0.49–0.55).

Conclusion

In this retrospective cohort, use of GLP-1 RAs was associated with lower risk of AF in non-dialysis CKD patients, even those without diabetes or obesity.