Sodium-Glucose Cotransporter 2 Inhibitors Decrease Contrast Induced Nephropathy In Patients With Heart Failure With Reduced Ejection Fraction Without Diabetes Mellitus

The aim of our study was to investigate the effect of sodium-glucose cotransporter 2 inhibitors (SGLT2i) treatment on the development of contrast induced nephropathy (CIN) in patients with heart failure with reduced ejection fraction (HFrEF) without diabetes mellitus (DM) undergoing elective coronary angiography (CAG) and percutaneous coronary intervention (PCI). In this retrospective study after exclusion criteria, 390 patients (242 men, 148 women, mean age 63.7 ± 8.6 years) were included. Patients were divided into two groups as with and without CIN and all parameters were compared and the parameters determining the patient group with CIN were found. CIN occurred in 76 (19.5%) of 390 patients. Age (p = < 0.001), smoking (p = 0.015), total procedure time (p = 0.018), contrast volume (p = < 0.001) and PCI (p = 0.030) were significantly higher and left ventricular ejection fraction (LVEF) (p = < 0.001) and SGLT2i use were lower (p = 001) in the CIN group. In the logistic regression analysis, it was found that advanced age (OR = 1.215, %95CI-1.144‒1.290, p < 0.001), low LVEF (OR = 0.858, %95 CI-0.807‒0.912, p < 0.001), increased contrast volume (OR = 1.030, %95 CI-1.016‒1.044, p < 0.001) and not using SGLT2i treatment (OR = 0.269, %95 CI-0.163‒0.454, p < 0.001) were found to independently determine the risk of CIN. In conclusion, SGLT2i treatment significantly reduced the development of CIN in HFrEF patients without DM. Our findings need to be supported by multicenter prospective randomized controlled trials.