SGLT2i use was associated with a significantly higher incidence of contrast-induced acute kidney injury in patients with T2DM undergoing CAG or PCI (OR 2.384, P=0.003).
Cohort (n=2,082)
Yes
Does the use of SGLT2 inhibitors affect the risk of contrast-induced acute kidney injury in patients with type 2 diabetes undergoing coronary angiography or PCI?
In patients with type 2 diabetes undergoing coronary angiography or PCI, SGLT2 inhibitor use may be associated with an increased risk of contrast-induced acute kidney injury.
Effect estimate: OR 2.384
p-value: p=0.003
Objective To investigate the association between different classes of hypoglycemic agents and the occurrence of contrast-induced acute kidney injury (CIAKI) in patients with type 2 diabetes mellitus (T2DM) undergoing coronary angiography (CAG) or percutaneous coronary intervention (PCI). Methods This retrospective cohort study included 2082 patients with T2DM who underwent CAG or PCI at two tertiary hospitals between January 2020 and December 2022. Patients were categorized into CIAKI and non-CIAKI groups, and baseline characteristics and short-term in-hospital outcomes were compared. The effects of sodium–glucose cotransporter-2 inhibitors (SGLT2i) use and other classes of glucose-lowering agents on the incidence of CIAKI were evaluated. Multivariable logistic regression analysis was performed to identify factors associated with the occurrence of CIAKI. Propensity score matching was further applied to assess the associations between different glucose-lowering agents and CIAKI as well as adverse cardiovascular outcomes. Results The incidence of CIAKI was 11.7% (244/2082). Patients with CIAKI had significantly worse short-term in-hospital outcomes. In multivariable logistic regression analysis, SGLT2i use (OR = 1.892, P = 0.040), total cholesterol (OR = 1.494, P = 0.002), elevated blood urea nitrogen (OR = 1.082, P = 0.022), and diuretic use (OR = 3.389, P < 0.001) were associated with an increased risk of CIAKI. After propensity score matching, SGLT2i use remained associated with a higher incidence of CIAKI (OR = 2.384, P = 0.003), DPP4 inhibitor use was associated with a lower observed incidence of CIAKI (OR = 0.179, P = 0.027). In contrast, no statistically significant associations were observed for other glucose-lowering agents with respect to CIAKI or overall adverse cardiovascular outcomes. Conclusions SGLT2i use may be associated with a higher incidence of CIAKI in patients with T2DM undergoing CAG or PCI. These findings may aid risk stratification and clinical management. Further research is needed to clarify the underlying mechanisms.
Guo et al. (Wed,) conducted a cohort in Type 2 diabetes mellitus undergoing coronary angiography or percutaneous coronary intervention (n=2,082). Sodium-glucose cotransporter-2 inhibitors (SGLT2i) vs. Non-use / other glucose-lowering agents was evaluated on Contrast-induced acute kidney injury (CIAKI) (OR 2.384, p=0.003). SGLT2i use was associated with a significantly higher incidence of contrast-induced acute kidney injury in patients with T2DM undergoing CAG or PCI (OR 2.384, P=0.003).