Po-02-161 effects of sglt2i on reducing dementia risks in atrial fibrillation patients with diabetes : a nationwide cohort

It is unknown whether sodium-glucose cotransporter-2 inhibitor (SGLT2i) reduces new-onset cognitive dysfunction in atrial fibrillation (AF) patients with diabetes. The purpose of this study was to investigate whether SGLT2i reduces the risk of dementia among patients with AF who have diabetes. In this study, we identified AF patients based on the Taiwanese National Health Insurance Research Database (2013-2014). In total, 17925 AF patients under 18 years old without prior dementia history were studied. Among AF patients, 1374 patients were prescribed for SGLT2i. By using the same propensity-score, the SGLT2i group was matched 1:2 with patients without SGLT2i (N=2747). Dementia events were followed through the end of 2019. Subtypes of dementia were investigated using competing risk models. During a follow-up period of 5 years, a total of 354 new-onset dementia events occurred during follow-up. In AF patients with diabetes receiving SGLT2i, the number of dementia events significantly decreased (HR: 0.71, 95% CI: 0.56-0.90). As a result of SGLT2i use, vascular dementia risk was only decreased (HR: 0.42, 95% CI: 0.22-0.79), especially among older people (over 65 years old, HR: 0.28, 95% CI: 0.08-0.94; P-value for interaction = 0.06), but not among older people (65 years old, HR: 0.77, 95% CI: 0.59-1.01), Neither rhythm control therapy nor medication reduced vascular dementia risk. There was a decreased risk of vascular dementia associated with the use of SGLT2i in AF patients with diabetes. As a result of reducing the effects of vascular risk factors on cognitive outcomes in AF patients, SGLT2i may improve 5-year cognitive outcomes.