Background: Antihyperglycermic drugs have been linked to new-onset atrial fibrillation (NAF); however, the effect of different class antihyperglycermic drugs on the development of NAF in elderly patients with diabetes millitus (DM) has not been well studied.
Objectives: We investigated the association between different class antihyperglycermic drugs and NAF in elderly patients.
Methods: This was a retrospective cohort study performed using database of National Health Insurance Program in Taiwan from January 2000 to December 2011. Prescriptions for antihyperglycermic drug before the index date were retrieved from a prescription database. A total of 1931 participants aged 65 and older who were newly diagnosed with atrial fibrillation from 2005 to 2011 were assigned to the NAF group, whereas 7724 sex-matched, age-matched, diabetes duration-matched, and propensity score-matched randomly selected participants without NAF served as the non-NAF group.The multivariable logistic regression modle was used to estimate the odds ratios (ORs) and 95% confence interval (CI) of NAF associated with different class antihyperglycermic agent use. Non-users served as the reference group.
Results: The overall risk of NAF was netural effect (OR, 0.93; 95% CI, 0.831.04) between NAF and non-NAF group. The risk of NAF after adjusting for sex, age, comorbilities, and concurrent medication was higher among users of insulins (OR, 1.58; 95% CI, 1.371.82) than among non-users. Patients who took dipeptidyl peptidase four inhibitors (OR, 0.65; 95% CI, 0.450.93) was at lower risk of developing NAF than non-users. Metformins, acarboses, glinides, sulfonylureas and thiazolidinediones were not associated with risk of NAF.
Conclusion: In this population, dipeptidyl peptidase four inhibitors are at lower risk of NAF. Insulins was associated with a significant increase in the risk of NAF during long-term follow-up.