Cardiovascular Center Aalst, OLV-Clinic, Aalst, Belgium; Dept. of Advanced Biomedical Sciences, University Federico II, Naples, Italy.
Cardiology Unit, Cardiac Thoracic and Vascular Department, IRCCS Azienda Ospedaliera-Universitaria di Bologna, Department of Medical and Surgical Sciences - DIMEC, Alma Mater Studiorum, University of Bologna, Italy.
Diabetes Res Clin Pract. 2023 Aug;202:110766. doi: 10.1016/j.diabres.2023.110766. Epub 2023 Jun 3.
To analyze the association between chronic SGLT2-I treatment and development of contrast-induced acute kidney injury (CI-AKI) in diabetic patients with acute myocardial infarction (AMI) undergoing PCI.
Multicenter international registry of consecutive patients with type 2 diabetes mellitus (T2DM) and AMI undergoing PCI between 2018 and 2021. The study population was stratified by the presence of chronic kidney disease (CKD) and anti-diabetic therapy at admission (SGLT2-I versus non-SGLT2-I users).
The study population consisted of 646 patients: 111 SGLT2-I users [28 (25.2%) with CKD] and 535 non-SGLT2-I users [221 (41.3%) with CKD]. The median age was 70 [61-79] years. SGLT2-I users exhibited significantly lower creatinine values at 72 h after PCI, both in the non-CKD and CKD stratum. The overall rate of CI-AKI was 76 (11.8%), significantly lower in SGLT2-I users compared to non-SGLT2-I patients (5.4% vs 13.1%, p = 0.022). This finding was also confirmed in patients without CKD (p = 0.040). In the CKD cohort, SGLT2-I users maintained significantly lower creatinine values at discharge. The use of SGLT2-I was an independent predictor of reduced rate of CI-AKI (OR 0.356; 95%CI 0.134-0.943, p = 0.038).
In T2DM patients with AMI, the use of SGLT2-I was associated with a lower risk of CI-AKI, mostly in patients without CKD.
分析慢性 SGLT2-I 治疗与接受经皮冠状动脉介入治疗（PCI）的糖尿病合并急性心肌梗死（AMI）患者对比剂诱导的急性肾损伤（CI-AKI）发展之间的相关性。
这是一项对 2018 年至 2021 年间连续接受 PCI 的 2 型糖尿病（T2DM）合并 AMI 患者的多中心国际注册研究。研究人群按慢性肾脏病（CKD）的存在和入院时的抗糖尿病治疗（SGLT2-I 与非 SGLT2-I 使用者）进行分层。
研究人群包括 646 例患者：111 例 SGLT2-I 使用者[28 例（25.2%）合并 CKD]和 535 例非 SGLT2-I 使用者[221 例（41.3%）合并 CKD]。中位年龄为 70[61-79]岁。SGLT2-I 使用者在 PCI 后 72 小时的肌酐值明显更低，无论在非 CKD 还是 CKD 分层中均如此。总的 CI-AKI 发生率为 76（11.8%），SGLT2-I 使用者明显低于非 SGLT2-I 患者（5.4%比 13.1%，p=0.022）。在无 CKD 的患者中也得到了证实（p=0.040）。在 CKD 队列中，SGLT2-I 使用者在出院时的肌酐值仍明显较低。SGLT2-I 的使用是 CI-AKI 发生率降低的独立预测因素（OR 0.356；95%CI 0.134-0.943，p=0.038）。
在 AMI 的 T2DM 患者中，SGLT2-I 的使用与 CI-AKI 的风险降低相关，尤其是在无 CKD 的患者中。
