The Incidence of Contrast-induced Acute Kidney Injury in Patients on Dapagliflozin Undergoing Percutaneous Coronary Interventions
Hany Hassan Ebaid
Cardiovascular Medicine Department, Faculty of Medicine, Benha University, Qalyubia, Egypt.
Ahmed Bahaa El Dein Abd El Hafeez *
Cardiovascular Medicine Department, National Heart Institute, Cairo, Egypt.
Khaled Emad El Dein El Rabat
Cardiovascular Medicine Department, Faculty of Medicine, Benha University, Qalyubia, Egypt.
Karim Elakabawi
Cardiovascular Medicine Department, Faculty of Medicine, Benha University, Qalyubia, Egypt.
*Author to whom correspondence should be addressed.
Abstract
Background: Sodium glucose cotransporter 2 receptor inhibitor (SGLT2i) dapagliflozin protects the renal function of individuals with coronary artery disease (CAD) and reduces incidence of contrast-induced acute kidney injury (CI-AKI) among individuals having percutaneous coronary interventions (PCI). The purpose of this work was to assess the CI-AKI incidence across individuals on dapagliflozin underwent PCI.
Methods: This single-center, prospective observational work had been conducted on 200 diabetic individuals ranging in age between 25 and 80 years old, both genders, with CAD were going to have elective coronary angiogram and PCI. We identified CI-AKI by the ESUR and KDIGO definition. Patients were divided into two equal groups: Group I: Type 2 diabetes mellitus (T2DM) were on dapagliflozin (SGLT2i) and group II: T2DM were on non SGLT2i glucose-lowering drugs.
Results: CI AKI according to European society of urogenital radiology (ESUR) and kidney disease improving global outcome score were significantly higher among group II contrasted to group I (P<0.05). no significant correlations existed between contrast volume and creatinine post-PCI, estimated glomerular filtration rate (eGFR) post-PCI, high-density lipoprotein, total cholesterol, and hemoglobin A1c in both groups. Dapagliflozin use was significantly correlated with 76.2% risk reduction of AKI. Dapagliflozin usage had been correlated with a 72.6% risk reduction of AKI but with borderline significance (P = 0.064). eGFR post-PCI was significantly greater among group I cootrasted to group II (P <0.05).
Conclusions: Regarding the predictors of AKI according to ESUR criteria, multivariate logistic regression analysis and demonstrated that using dapagliflozin was substantially correlated with 76.2% risk reduction of AKI controlling for age, sex, hypertension, smoking, and dyslipidemia.
Keywords: Contrast-induced acute kidney injury, dapagliflozin, percutaneous coronary interventions, coronary artery disease