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American Journal of Cardiovascular Drugs

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11.10.2024 | Systematic Review

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

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

Erschienen in: American Journal of Cardiovascular Drugs | Ausgabe 1/2025

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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.

Graphical Abstract

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Titel: 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
verfasst von: Kyriakos Dimitriadis
Angeliki Vakka
Nikolaos Pyrpyris
Anastasios Apostolos
Eirini Beneki
Elpiniki Stathopoulou
Panagiota Giannou
Panagiotis Tsioufis
Panagiotis Iliakis
Konstantinos Aznaouridis
Dimitrios Petras
Konstantinos Tsioufis
Publikationsdatum: 11.10.2024
Verlag: Springer International Publishing
Erschienen in: American Journal of Cardiovascular Drugs / Ausgabe 1/2025
Print ISSN: 1175-3277
Elektronische ISSN: 1179-187X
DOI: https://doi.org/10.1007/s40256-024-00684-y

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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