Dapagliflozin on acute kidney injury and prognosis in patients with diabetes mellitus type 2 and acute coronary syndrome after percutaneous coronary intervention
- VernacularTitle:达格列净对2型糖尿病合并急性冠脉综合征患者PCI后急性肾损伤及预后的影响
- Author:
Huifang HAO
1
;
Xiufeng ZHAI
2
;
Qing LI
1
;
Shicheng YANG
3
;
Peng ZHANG
3
Author Information
1. Dept. of Nephrology，Tianjin TEDA Hospital，Tianjin 300451，China
2. Tianjin Rehabilitation and Recuperation Center，Joint Logistics Support Force，Tianjin 300381，China
3. Dept. of Cardiology，Tianjin Chest Hospital，Tianjin 300222，China
- Publication Type:Journal Article
- Keywords:
dapagliflozin;
acute coronary syndrome;
diabetes mellitus type 2;
percutaneous coronary intervention;
contrast
- From:
China Pharmacy
2025;36(4):469-474
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVE To investigate the impact of dapagliflozin on contrast-induced acute kidney injury （CIAKI） and prognosis in patients with diabetes mellitus type 2 （T2DM） and acute coronary syndrome （ACS） who underwent percutaneous coronary intervention （PCI）. METHODS Retrospective selection of data on T2DM patients with ACS who underwent PCI treatment in the Cardiology Department of Tianjin Chest Hospital from January 1st 2021 to December 31st 2022. The patients were divided into dapagliflozin group （96 cases） and control group （148 cases） based on whether they received dapagliflozin or not. Renal function indicators were measured for all enrolled patients before PCI and at 48 h and 1 week after PCI， including blood urea nitrogen （BUN）， serum creatinine （Scr）， estimated glomerular filtration rate （eGFR）， cystatin-C （Cys-C）， kidney injury molecule-1 （KIM-1） and β2-microglobulin （β2-MG）. All patients were followed up for at least 1 year. The incidence of CIAKI and major adverse cardiac event （MACE） during follow-up were recorded for both groups. Logistic regression was used to analyze the impact of dapagliflozin on the occurrence of CIAKI， while the Log-rank test was applied to compare the incidence of MACE between the two groups. Cox regression was employed to analyze the impact of dapagliflozin on prognosis. RESULTS At 48 h and 1 week after PCI， serum levels of Cys-C， KIM-1 and β2-MG were significantly lower in the dapagliflozin group compared to the control group （P＜0.05）. The incidence of CIAKI was lower in the dapagliflozin group compared to the control group （6.25% vs. 14.86%， P＝0.042）. Logistic regression analysis revealed that dapagliflozin was an independent protective factor against CIAKI （OR＝0.280， 95%CI 0.101-0.780，P＝0.015）. During the follow-up period， the incidence of MACE was lower in the dapagliflozin group compared to the control group （7.29% vs. 17.57%， P＝0.049）. Cox regression analysis indicated that dapagliflozin reduced the occurrence of MACE after PCI （HR＝0.374， 95%CI 0.161-0.866， P＝0.022）. CONCLUSIONS With adequate hydration， the use of dapagliflozin does not increase the risk of CIAKI following PCI in T2DM patients with ACS.
