Dapagliflozin Fails AF Burden After Catheter Ablation
- This text discusses the potential benefits of SGLT2 inhibitors (like dapagliflozin) on Atrial Fibrillation (AF), and presents the results of the DARE-AF trial, a study specifically designed to...
- * Background: Previous studies showing benefits of SGLT2 inhibitors on AF have all been in patients with existing conditions like diabetes, heart failure, or kidney disease.
- the DARE-AF trial did not demonstrate a benefit of dapagliflozin in reducing AF burden or recurrence in patients undergoing ablation for persistent AF who did not have diabetes,...
Summary of the DARE-AF Trial & SGLT2 Inhibitors and Atrial Fibrillation (AF)
This text discusses the potential benefits of SGLT2 inhibitors (like dapagliflozin) on Atrial Fibrillation (AF), and presents the results of the DARE-AF trial, a study specifically designed to investigate this in a population without typical indications for these drugs (diabetes, heart failure, or chronic kidney disease).
Here’s a breakdown of the key points:
* Background: Previous studies showing benefits of SGLT2 inhibitors on AF have all been in patients with existing conditions like diabetes, heart failure, or kidney disease. The mechanism may involve improving underlying conditions (heart failure, hypertension, obesity) which then positively impact the heart’s structure and electrical function.
* DARE-AF Trial Design:
* Participants: 200 patients undergoing first-time catheter ablation for persistent AF, without diabetes, heart failure, or chronic kidney disease.
* Intervention: Dapagliflozin 10mg daily + usual care vs. usual care alone for 3 months, starting within 24 hours of ablation.
* Primary Outcome: AF burden at 3 months (measured by a 7-day ECG patch).
* DARE-AF Trial Results:
* No Meaningful Benefit: Dapagliflozin did not significantly reduce AF burden (7.5% vs 8.1%,P=0.48) or cumulative AF recurrence (29.5% vs 28.0%, HR 1.11, 95% CI 0.66-1.86) compared to usual care.
* No Impact on Other Measures: Left atrial diameter reduction and improvements in quality of life (AFEQT scores) were also similar between groups.
* Safety: Dapagliflozin was safe, with no difference in serious adverse events.
* Compliance: Good adherence to the dapagliflozin regimen was reported (86% compliance, 90% glycosuria positivity).
the DARE-AF trial did not demonstrate a benefit of dapagliflozin in reducing AF burden or recurrence in patients undergoing ablation for persistent AF who did not have diabetes, heart failure, or chronic kidney disease. This suggests that the observed benefits of SGLT2 inhibitors on AF in previous studies might potentially be linked to their effects on these underlying comorbidities.