AIMS Sodium-glucose cotransporter-2 inhibitors (SGLT-2is) are antidiabetic drugs that have beneficial direct effects on the myocardium by impacting cardiac ion channels and exchangers that control cardiac electrophysiology. We investigated the relationship between SGLT-2is in comparison to glucagon-like peptide-1 receptor agonists (GLP-1as) and out-of-hospital cardiac arrest (OHCA) in individuals with type 2 diabetes. METHODS Using data from Danish registries, we conducted a nationwide nested case-control study in a cohort of individuals with type 2 diabetes between 2013 and 2019. Cases were defined as OHCA victims from presumed cardiac causes and each case was randomly matched with five controls without OHCA based on age, sex, and index-date (OHCA date). Conditional logistic regression models were used to estimate the adjusted odds ratios (ORs) with 95% confidence interval (95% CI) of OHCA comparing SGLT-2i use with GLP-1as (reference). RESULTS The study population consisted of 3618 OHCA cases and 18 090 matched controls. SGLT-2i was used by 91 cases and 593 controls, and was associated with reduced odds of OHCA compared with use of GLP-1a after controlling for the relevant confounders (adjusted OR 0.76 [95% CI:0.58-0.99]). The adjusted OR of OHCA associated with SGLT-2i use did not vary significantly by sex (P-value interaction: 0.461), pre-existing cardiac disease (P-value interaction: 0.762), heart failure (P-value interaction: 0.891), diabetes duration (P-value interaction: 0.101), and chronic kidney disease (P-value interaction: 0.894). CONCLUSION Use of SGLT-2i is associated with a reduced risk of OHCA compared with use of GLP-1a in type 2 diabetes.

中文翻译：

---

钠-葡萄糖协同转运蛋白 2 抑制剂与胰高血糖素样肽 1 受体激动剂和 2 型糖尿病院外心脏骤停的比较：一项全国巢式病例对照研究。

AIMS 钠-葡萄糖协同转运蛋白 2 抑制剂 (SGLT-2is) 是一种抗糖尿病药物，通过影响控制心脏电生理学的心脏离子通道和交换器，对心肌产生有益的直接影响。我们研究了 SGLT-2is 与胰高血糖素样肽 1 受体激动剂 (GLP-1as) 相比与 2 型糖尿病患者院外心脏骤停 (OHCA) 之间的关系。方法 利用丹麦登记处的数据，我们在 2013 年至 2019 年间对 2 型糖尿病患者队列进行了一项全国范围内的巢式病例对照研究。病例被定义为推测为心脏病原因的 OHCA 受害者，每个病例随机与 5 名对照组进行匹配，但没有OHCA 基于年龄、性别和索引日期（OHCA 日期）。使用条件逻辑回归模型来估计 OHCA 的调整优势比 (OR) 和 95% 置信区间 (95% CI)，比较 SGLT-2i 与 GLP-1as（参考）的使用。结果 研究人群包括 3618 名 OHCA 病例和 18090 名匹配对照者。91 例病例和 593 名对照者使用了 SGLT-2i，在控制相关混杂因素后，与使用 GLP-1a 相比，SGLT-2i 与 OHCA 发生几率降低相关（调整后 OR 0.76 [95% CI:0.58-0.99]）。与 SGLT-2i 使用相关的 OHCA 调整后 OR 并没有因性别（P 值交互作用：0.461）、既往心脏病（P 值交互作用：0.762）、心力衰竭（P 值交互作用：0.891）而显着变化。 、糖尿病病程（P 值交互作用：0.101）和慢性肾脏病（P 值交互作用：0.894）。结论 与使用 GLP-1a 相比，在 2 型糖尿病中使用 SGLT-2i 可以降低 OHCA 风险。