Efficacy of Chronic Use of Sodium-Glucose Co-transporter 2 Inhibitors on the Prevention of Contrast-Induced Acute Kidney Injury in Patients with Type 2 Diabetes Mellitus Following Coronary Procedures: A Systematic Review and Meta-Analysis.

IF 2.8 4区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

American Journal of Cardiovascular Drugs Pub Date : 2024-10-11 DOI:10.1007/s40256-024-00684-y

Kyriakos Dimitriadis, Angeliki Vakka, Nikolaos Pyrpyris, Anastasios Apostolos, Eirini Beneki, Elpiniki Stathopoulou, Panagiota Giannou, Panagiotis Tsioufis, Panagiotis Iliakis, Konstantinos Aznaouridis, Dimitrios Petras, Konstantinos Tsioufis

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引用次数: 0

Abstract

Introduction: Contrast-induced acute kidney injury (CI-AKI) is a common complication of iodinated contrast administration during coronary procedures, especially in patients with diabetes mellitus (DM). Besides periprocedural hydration and statins, there are no other pharmacological strategies with consistent results to prevent CI-AKI up to date. This study aims to evaluate the efficacy of chronic use of sodium-glucose co-transporter 2 (SGLT2) inhibitors on the prevention of CI-AKI in patients with type 2 DM following coronary procedures.

Methods: A systematic literature search of MEDLINE, Google Scholar, Embase, and Cochrane Library was performed. Relevant observational studies and randomized controlled studies (RCTs) were identified. Results were pooled using a random-effect model meta-analysis. Subgroup analyses were performed to evaluate the potential benefit of SGLT2 inhibitors on the prevention of CI-AKI in patients undergoing urgent or elective coronary angiography/percutaneous coronary interventions (CAG/PCI).

Results: Seven observational studies and one randomized controlled trial with 2740 patients were included. Chronic treatment (minimum duration 2 weeks to 6 months) with an SGLT2 inhibitor was associated with a significantly reduced risk of CI-AKI in diabetic patients undergoing coronary procedures compared with the control group [risk ratio (RR) 0.48; 95% confidence interval (CI) 0.39-0.59; p < 0.001). Results of subsequent subgroup analysis showed a significant reduction in the incidence of CI-AKI in diabetic patients undergoing both elective CAG/PCI (RR 0.49; 95% CI 0.35-0.68; p<0.001) and urgent CAG/PCI (RR 0.48; 95% Cl 0.35-0.66; p < 0.001).

Discussion: Chronic use of SGLT2 inhibitors may be preventative against the incidence of CI-AKI in patients with type 2 DM undergoing coronary interventions. Further RCTs are needed to confirm our findings.

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长期使用钠-葡萄糖协同转运体 2 抑制剂对预防冠状动脉手术后 2 型糖尿病患者因对比度引起的急性肾损伤的疗效：系统回顾与元分析》。

导言：造影剂诱发的急性肾损伤（CI-AKI）是冠状动脉手术中使用碘造影剂的常见并发症，尤其是在糖尿病（DM）患者中。除了围术期水化和他汀类药物外，迄今为止还没有其他药理策略能有效预防 CI-AKI。本研究旨在评估长期使用钠-葡萄糖协同转运体 2（SGLT2）抑制剂对预防冠状动脉手术后 2 型糖尿病患者 CI-AKI 的疗效：对 MEDLINE、Google Scholar、Embase 和 Cochrane Library 进行了系统性文献检索。确定了相关的观察性研究和随机对照研究（RCT）。采用随机效应模型荟萃分析对结果进行汇总。进行了亚组分析，以评估SGLT2抑制剂对接受紧急或择期冠状动脉造影术/经皮冠状动脉介入治疗（CAG/PCI）患者预防CI-AKI的潜在益处：结果：共纳入了 7 项观察性研究和 1 项随机对照试验，共 2740 名患者。与对照组相比，接受冠状动脉手术的糖尿病患者接受 SGLT2 抑制剂的长期治疗（最短疗程为 2 周至 6 个月）可显著降低 CI-AKI 风险[风险比 (RR) 0.48；95% 置信区间 (CI) 0.39-0.59；P < 0.001]。随后的亚组分析结果显示，接受择期 CAG/PCI 手术的糖尿病患者的 CI-AKI 发生率显著降低（RR 0.49；95% CI 0.35-0.68；p 讨论：长期使用 SGLT2 抑制剂可预防接受冠状动脉介入治疗的 2 型糖尿病患者的 CI-AKI 发生率。需要进一步的 RCT 研究来证实我们的发现。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

American Journal of Cardiovascular Drugs 医学-心血管系统

CiteScore

6.70

自引率

3.30%

发文量

审稿时长

>12 weeks

期刊介绍： Promoting rational therapy within the discipline of cardiology, the American Journal of Cardiovascular Drugs covers all aspects of the treatment of cardiovascular disorders, particularly the place in therapy of newer and established agents. Via a program of reviews and original clinical research articles, the journal addresses major issues relating to treatment of these disorders, including the pharmacology, efficacy and adverse effects of the major classes of drugs; information on newly developed drugs and drug classes; the therapeutic implications of latest research into the aetiology of cardiovascular disorders; and the practical management of specific clinical situations. The American Journal of Cardiovascular Drugs offers a range of additional enhanced features designed to increase the visibility, readership and educational value of the journal’s content. Each article is accompanied by a Key Points summary, giving a time-efficient overview of the content to a wide readership. Articles may be accompanied by plain language summaries to assist patients, caregivers and others in understanding important medical advances. The journal also provides the option to include various other types of enhanced features including slide sets, videos and animations. All enhanced features are peer reviewed to the same high standard as the article itself. Peer review is conducted using Editorial Manager®, supported by a database of international experts. This database is shared with other Adis journals.