Research Article

Comparison of the effects of SGLT 2 inhibitors and sulfonylurea on electrocardiographic parameters

Volume: 43 Number: 1 March 31, 2021
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Comparison of the effects of SGLT 2 inhibitors and sulfonylurea on electrocardiographic parameters

Abstract

Objective: Tp-e, QT, and Tp-e / QT are parameters showing ventricular repolarization. The increase in these parameters causes an increase in cardiovascular mortality, mostly due to malignant arrhythmias. Our study aimed to compare the long-term changes in electrocardiographic parameters in patients with uncontrolled diabetes despite using metformin, with the addition of SGLT 2 inhibitor or sulfonylurea (SU) to the treatment.
Method: This retrospective study was enrolled in 133 type 2 DM patients with uncontrolled diabetes who applied to the internal medicine outpatient clinic, using single oral antidiabetic agents. The patients were divided into two groups as SU and SGLT 2 inhibitor additive. SU was added to the treatment of 69 patients, and SGLT 2 inhibitor was added to 64 patients. 12-lead superficial ECG records of participants who received combined therapy for at least six months were analyzed and compared. RR distance, QT interval, and Tp-e intervals were measured on the ECG. QTc was calculated using Bazzet's formula. (QT/ √ RR). Tp-e / QT and Tp-e / QTc ratios were calculated.
Results: Seventy-eight (58.6%) of the participants were female, and 55 (41.4) were male. The age and gender distribution of both groups were similar. The group to which SGLT 2 inhibitor was added, Tp-e, QT, and QTc distances were significantly lower than the SU group (p <0.001 for each). Also, the Tp-e / QT and Tp-e / QTc ratios were significantly greater in the SU group (0.210 ± 0.029 vs 0.190 ± 0.03; p <0.001 and 0.201 ± 0.051 vs 0.184 ± 0.032; p = 0.022 respectively).
Conclusions: In our study, we showed that the addition of SGLT2 inhibitors to monotherapy in people with diabetes with poor glycemic control has a positive effect on ECG parameters, which are indicators of repolarization, compared to other oral antidiabetics.

Keywords

References

  1. Ogurtsova K, da Rocha Fernandes JD, Huang Y, et al. IDF Diabetes Atlas: Global estimates for the prevalence of diabetes for 2015 and 2040. Diabetes Res Clin Pract 2017; 128: 40-50. doi: 10.1016/j.diabres.2017.03.024
  2. Scheen AJ. Cardiovascular Effects of New Oral Glucose-Lowering Agents: DPP-4 and SGLT-2 Inhibitors. Circ Res. 2018 May 11;122(10):1439-1459. doi: 10.1161/CIRCRESAHA.117.311588
  3. Pham SV, Chilton RJ. EMPA-REG OUTCOME: The Cardiologist's Point of View. Am J Cardiol. 2017 Jul 1;120(1S):S53-S58. DOI: 10.1016/j.amjcard.2017.05.011
  4. Gupta P, Patel C, Patel H, et al. T(p-e)/QT ratio as an index of arrhythmogenesis. J Electrocardiol 2008;41:567-74. doi: 10.1016/j.jelectrocard.2008.07.016
  5. Ardahanli I, Celik M. Comparison of Tp-e interval, QTc interval and Tp-e/QTc ratios between non-diabetic and prediabetic population. Ann Med Res 2020;27(12):3117-22. doi: 10.5455/annalsmedres.2020.09.949
  6. Tokatli A, Kiliçaslan F, Alis M, et al. Prolonged Tp-e interval, Tp-e/QT ratio and Tp-e/QTc ratio in patients with type 2 diabetes mellitus. Endocrinol Metab (Seoul) 2016;31:105-12. doi: 10.3803/EnM.2016.31.1.105
  7. Akhan O, Ardahanlı İ. Evaluation of Ventricular Polarization in Noncompaction Cardiomyopathy with Electrocardiography in a Different Perspective. ECM 2020;8(4):180-185. doi: 10.32596/ejcm.galenos.2020.08.044
  8. Braschi A, Frasheri A, Lombardo RM, et al. Association between Tpeak-Tend/QT and major adverse cardiovascular events in patients with Takotsubo syndrome. Acta Cardiol. 2020 Jun 12:1-7. doi: 10.1080/00015385.2020.1776012

Details

Primary Language

English

Subjects

Health Care Administration

Journal Section

Research Article

Authors

Publication Date

March 31, 2021

Submission Date

February 12, 2021

Acceptance Date

March 28, 2021

Published in Issue

Year 2021 Volume: 43 Number: 1

DOI

https://doi.org/10.7197/cmj.879083

IZ

https://izlik.org/JA26FB85AY

Cite

RIS / Bibtex
AMA
1.Akhan O, Şahin E, Aslan R, Aktaş A. Comparison of the effects of SGLT 2 inhibitors and sulfonylurea on electrocardiographic parameters. CMJ. 2021;43(1):49-54. doi:10.7197/cmj.879083

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