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.

Journal

American journal of cardiovascular drugs : drugs, devices, and other interventions
ISSN: 1179-187X
Titre abrégé: Am J Cardiovasc Drugs
Pays: New Zealand
ID NLM: 100967755

Informations de publication

Date de publication:
11 Oct 2024
Historique:
accepted: 21 09 2024
medline: 11 10 2024
pubmed: 11 10 2024
entrez: 11 10 2024
Statut: aheadofprint

Résumé

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. 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). 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). 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.

Identifiants

DOI: 10.1007/s40256-024-00684-y PMID: 39392560
pubmed: 39392560
doi: 10.1007/s40256-024-00684-y
pii: 10.1007/s40256-024-00684-y
doi:

Types de publication

Journal Article Systematic Review

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

© 2024. The Author(s), under exclusive licence to Springer Nature Switzerland AG.

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Auteurs

Kyriakos Dimitriadis (K)

First Department of Cardiology, School of Medicine, National and Kapodistrian University of Athens, Hippokration General Hospital, Vasilissis Sofias 114, 115 27, Athens, Greece. dimitriadiskyr@yahoo.gr.

Angeliki Vakka (A)

First Department of Cardiology, School of Medicine, National and Kapodistrian University of Athens, Hippokration General Hospital, Vasilissis Sofias 114, 115 27, Athens, Greece.

Nikolaos Pyrpyris (N)

First Department of Cardiology, School of Medicine, National and Kapodistrian University of Athens, Hippokration General Hospital, Vasilissis Sofias 114, 115 27, Athens, Greece.

Anastasios Apostolos (A)

First Department of Cardiology, School of Medicine, National and Kapodistrian University of Athens, Hippokration General Hospital, Vasilissis Sofias 114, 115 27, Athens, Greece.

Eirini Beneki (E)

First Department of Cardiology, School of Medicine, National and Kapodistrian University of Athens, Hippokration General Hospital, Vasilissis Sofias 114, 115 27, Athens, Greece.

Elpiniki Stathopoulou (E)

Service of Nephrology, Hippokration General Hospital, University Hospital of Athens, Athens, Greece.

Panagiota Giannou (P)

Service of Nephrology, Hippokration General Hospital, University Hospital of Athens, Athens, Greece.

Panagiotis Tsioufis (P)

First Department of Cardiology, School of Medicine, National and Kapodistrian University of Athens, Hippokration General Hospital, Vasilissis Sofias 114, 115 27, Athens, Greece.

Panagiotis Iliakis (P)

First Department of Cardiology, School of Medicine, National and Kapodistrian University of Athens, Hippokration General Hospital, Vasilissis Sofias 114, 115 27, Athens, Greece.

Konstantinos Aznaouridis (K)

First Department of Cardiology, School of Medicine, National and Kapodistrian University of Athens, Hippokration General Hospital, Vasilissis Sofias 114, 115 27, Athens, Greece.

Dimitrios Petras (D)

Service of Nephrology, Hippokration General Hospital, University Hospital of Athens, Athens, Greece.

Konstantinos Tsioufis (K)

First Department of Cardiology, School of Medicine, National and Kapodistrian University of Athens, Hippokration General Hospital, Vasilissis Sofias 114, 115 27, Athens, Greece.

Classifications MeSH