B-PO05-144 COMPARING SODIUM GLUCOSE COTRANSPORTER 2 INHIBITORS AND DIPEPTIDYL PEPTIDASE-4 INHIBITORS ON NEW-ONSET ATRIAL FIBRILLATION AND ISCHEMIC STROKE

Abstract

Given the susceptibility of patients with type 2 diabetes mellitus towards cerebrovascular complications, there is increasing research on the cerebrovascular-protective effects of novel anti-diabetic agents. However, few studies have compared sodium glucose cotransporter-2 inhibitor (SGLT2I) and dipeptidyl peptidase-4 inhibitor (DPP4I) in their effects on stroke and atrial fibrillation (AF). To evaluate the risk of ischemic stroke and AF between SGLT2I and DPP4I users in the Hong Kong population. The study consists of patients with type-2 diabetes mellitus prescribed with SGLT2I/DPP4I between January 1st, 2015 and December 31st, 2019 by centers under the Hong Kong Hospital Authority. The primary outcome was new-onset ischemic stroke and AF. Analysis for new-onset stroke and AF excluded those of a past history of the respective conditions. Propensity-score matching was performed to generate control for SGLT2I users to compare against DPP4I users in a 1:2 ratio. Cox regression analysis was used to identify outcome predictors and assess the effects of SGLT2I/DPP4I use on new-onset stroke and AF after adjusting for confounders. A total of 69521 patients were identified: from which 49108 (55.3% male, baseline age: 66.5±12.9 years old) and 49563 (55.0% male, baseline age: 66.7±13.0 years old) patients were included for the analysis for new-onset AF and stroke respectively. The multivariate Cox analysis adjusted for demographics, comorbidities and concomitant medication use demonstrates SGLT2I users had a lower risk for new-onset AF (hazard ratio [HR]: 0.57, 95% confidence interval [CI]: [0.36, 0.88], p= 0.013) and stroke (HR= 0.41, 95% CI= [0.32, 0.61], p < 0.0001) than DPP4I users. SLGT2I users have a lower risk of new-onset stroke and AF compared to DPP4I users.