title: Thiazolidinediones are associated with a decreased risk of atrial fibrillation compared with other antidiabetic treatment: a nationwide cohort study.
abstract: The aim of this study was to investigate the association between thiazolidinediones (TZDs) vs. other antidiabetic drugs and risk of atrial fibrillation (AF) in diabetic patients.
  
  
  
  Diabetes mellitus (diabetes) increases the risk of AF by approximately 34%. TZD is an insulin sensitizer that also has anti-inflammatory effects, which might decrease the risk of AF compared with other antidiabetic drugs. We used data from the Danish nationwide registries to study 108 624 patients with diabetes and without prior AF who were treated with metformin or sulfonylurea as first-line drugs. The incidence of AF was significantly lower with TZD as the second-line antidiabetic treatment compared with other second-line antidiabetic drugs (P < 0.001). The 10 year cumulative incidence [95% confidence interval (95% CI)] of AF was 6.2% (3.1-9.3%) with TZD vs. 10.2% (9.8-10.6%) with other antidiabetic drugs. The decreased risk of AF remained significant after adjusting for age, sex, and comorbidities with a hazard ratio (95% CI) of 0.76 (0.57-1.00), P = 0.047 associated with TZD treatment compared with other antidiabetic drugs.
  
  
  
  Use of a TZD to treat diabetes was associated with reduced risk of developing AF compared with other antidiabetic drugs as second-line treatment.
authors.affiliation: University Hospital Gentofte and Herlev, Kildegaardsvej 28, 2900 Hellerup, Copenhagen, Denmark.|Faculty of Health and Medical Sciences Blegdamsvej 3B, 2200, Copenhagen, Denmark.
authors.forename: Jannik Langtved
authors.initials: JL
authors.lastname: Pallisgaard
authors.affiliation: University Hospital Gentofte and Herlev, Kildegaardsvej 28, 2900 Hellerup, Copenhagen, Denmark.|Faculty of Health and Medical Sciences Blegdamsvej 3B, 2200, Copenhagen, Denmark.
authors.forename: Tommi Bo
authors.initials: TB
authors.lastname: Lindhardt
authors.affiliation: University Hospital Gentofte and Herlev, Kildegaardsvej 28, 2900 Hellerup, Copenhagen, Denmark.|Faculty of Health and Medical Sciences Blegdamsvej 3B, 2200, Copenhagen, Denmark.
authors.forename: Laila
authors.initials: L
authors.lastname: Staerk
authors.affiliation: University Hospital Gentofte and Herlev, Kildegaardsvej 28, 2900 Hellerup, Copenhagen, Denmark.
authors.forename: Jonas Bjerring
authors.initials: JB
authors.lastname: Olesen
authors.affiliation: Institute of Health Science and Technology, Fredrik Bajers Vej 7D, 9220 Aalborg, Denmark.
authors.forename: Christian
authors.initials: C
authors.lastname: Torp-Pedersen
authors.affiliation: Zealand University Hospital Roskilde, Sygehusvej 10, 4000 Roskilde, Denmark.
authors.forename: Morten Lock
authors.initials: ML
authors.lastname: Hansen
authors.affiliation: University Hospital Gentofte and Herlev, Kildegaardsvej 28, 2900 Hellerup, Copenhagen, Denmark.|Faculty of Health and Medical Sciences Blegdamsvej 3B, 2200, Copenhagen, Denmark.|Danish Heart Foundation, Vognmagergade 7, 3. sal, 1120 Copenhagen, Denmark.|National Institute of Public Health University of Southern Denmark, Oster Farimagsgade 5 A, 1353 Copenhagen, Denmark.
authors.forename: Gunnar Hilmar
authors.initials: GH
authors.lastname: Gislason
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001281:Atrial Fibrillation / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*; D003718:Denmark / Q000453:epidemiology; D003920:Diabetes Mellitus / Q000097:blood / Q000188:drug therapy* / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011159:Population Surveillance / Q000379:methods*; D015995:Prevalence; D012042:Registries; D012189:Retrospective Studies; D012307:Risk Factors; D045162:Thiazolidinediones / Q000627:therapeutic use*; D013997:Time Factors; D055815:Young Adult
chemical_list: D045162:Thiazolidinediones
keywords: Atrial fibrillation; Complications; Diabetes mellitus; Glitazones; Prevention; Thiazolidinediones