Effects of Glucagon-Like Peptide 1 Receptor Agonists on Atrial Fibrillation Recurrence After Catheter Ablation: A Systematic Review and Meta-analysis

IF 3.4 3区医学 Q2 MEDICINE, RESEARCH & EXPERIMENTAL Advances in Therapy Pub Date : 2024-08-14 DOI:10.1007/s12325-024-02959-x

Paschalis Karakasis, Nikolaos Fragakis, Dimitrios Patoulias, Panagiotis Theofilis, George Kassimis, Theodoros Karamitsos, Mohamed El-Tanani, Manfredi Rizzo

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Abstract

Introduction

Despite the technological advancements in catheter ablation strategies, the recurrence of atrial fibrillation (AF) post-ablation remains a concern that requires further investigation. Glucagon-like peptide 1 (GLP-1) receptor agonists have shown a significant effect on weight reduction, which in turn is associated with freedom from AF recurrence in both patients who are obese and not obese undergoing ablation. Therefore, we aimed to summarize the available evidence on the efficacy of GLP-1 receptor agonists in maintaining sinus rhythm post-ablation.

Methods

Medline, Cochrane Library, and Scopus were searched until June 9, 2024. Double-independent study selection, data extraction, and quality assessment were performed. Evidence was pooled using DerSimonian-Laird random effects meta-analysis.

Results

Three propensity score-matched studies (n = 6031 participants) were analyzed. Over a 12-months follow-up, the use of GLP-1 receptor agonists was associated with a significant reduction in AF recurrence compared to controls, hazard ratio (HR) = 0.549, 95% confidence interval (CI) = [0.315, 0.956], P = 0.034; I² = 57%. No significant heterogeneity was observed (Q statistic = 4.6, heterogeneity P = 0.1).

Conclusion

The use of GLP-1 receptor agonists is associated with a lower risk of AF recurrence in patients receiving AF ablation therapy. Further large-scale randomized trials are necessary to explore the efficacy of GLP-1 receptor agonists in maintaining ablation outcomes over the long term.

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胰高血糖素样肽 1 受体激动剂对导管消融术后心房颤动复发的影响：系统回顾与元分析》。

导言：尽管导管消融策略的技术不断进步，但消融后心房颤动（房颤）的复发仍然是一个需要进一步研究的问题。胰高血糖素样肽 1（GLP-1）受体激动剂对减轻体重有显著效果，而减轻体重又与接受消融术的肥胖和非肥胖患者不再复发房颤有关。因此，我们旨在总结有关 GLP-1 受体激动剂在消融术后维持窦性心律方面疗效的现有证据：方法：检索 Medline、Cochrane Library 和 Scopus，直至 2024 年 6 月 9 日。进行了双重独立的研究筛选、数据提取和质量评估。使用 DerSimonian-Laird 随机效应荟萃分析对证据进行汇总：对三项倾向得分匹配研究（n = 6031 名参与者）进行了分析。在12个月的随访中，与对照组相比，使用GLP-1受体激动剂可显著降低房颤复发率，危险比（HR）= 0.549，95%置信区间（CI）= [0.315，0.956]，P = 0.034；I2 = 57%。未观察到明显的异质性（Q统计量=4.6，异质性P=0.1）：结论：在接受房颤消融治疗的患者中，使用 GLP-1 受体激动剂可降低房颤复发风险。有必要进一步开展大规模随机试验，探讨 GLP-1 受体激动剂在长期保持消融疗效方面的功效。

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来源期刊

Advances in Therapy 医学-药学

CiteScore

7.20

自引率

2.60%

发文量

353

审稿时长

6-12 weeks

期刊介绍： Advances in Therapy is an international, peer reviewed, rapid-publication (peer review in 2 weeks, published 3–4 weeks from acceptance) journal dedicated to the publication of high-quality clinical (all phases), observational, real-world, and health outcomes research around the discovery, development, and use of therapeutics and interventions (including devices) across all therapeutic areas. Studies relating to diagnostics and diagnosis, pharmacoeconomics, public health, epidemiology, quality of life, and patient care, management, and education are also encouraged. The journal is of interest to a broad audience of healthcare professionals and publishes original research, reviews, communications and letters. The journal is read by a global audience and receives submissions from all over the world. Advances in Therapy will consider all scientifically sound research be it positive, confirmatory or negative data. Submissions are welcomed whether they relate to an international and/or a country-specific audience, something that is crucially important when researchers are trying to target more specific patient populations. This inclusive approach allows the journal to assist in the dissemination of all scientifically and ethically sound research.