Synergistic Effects of SGLT2 Inhibitors and GLP-1R Agonists on Inflammation-Associated Oxidative Stress in Atrial Fibrillation

Atrial fibrillation (AF) is linked to atrial inflammation and adverse remodeling. The authors analyzed 80 right atrial appendages from cardiac surgery patients, including 18 with AF history, to examine the relationship between inflammation and sodium-glucose cotransporter 2 (SGLT2) and glucagon-like peptide 1 receptor (GLP-1R) expression and function. Inflamed right atrial appendages showed increased oxidative stress, fibrosis, and SGLT2 and GLP-1R expression, which were more pronounced in patients with AF. SGLT2 inhibitors and GLP-1R agonists reduced reactive oxygen species levels, with combination therapy being most effective. These findings suggest combined SGLT2 inhibitor and GLP-1R agonist treatment could be a potential approach to prevent AF-related atrial remodeling by reducing oxidative stress.