Impact of dapagliflozin on incidence of contrast-induced nephropathy and cardiovascular prognosis in elderly T2DM patients after PCI
Yang Shicheng
Zhang Peng
Cong Hongliang
Fu Naikuan
Abstract：Objective To investigate the impact of dapagliflozin on the incidence of contrast-induced nephropathy(CIN)and prognosis in elderly patients(＞60 years old)with type 2 diabetes mellitus(T2DM)undergoing percutaneous coronary intervention(PCI).Methods A retrospective study was conducted on 296 elderly T2DM patients who underwent PCI in our department from January 2021 to June 2022.With a propensity score matching at a ratio of 1∶1,according to ad-ministration of dapagliflozin or not,they were divided into a dapagliflozin group(148 cases)and a control group(148 cases).Changes in renal function,including blood urea nitrogen(BUN),serum creatinine(Cr),estimated glomerular filtration rate(eGFR),β2-microglobulin(β2-MG),cystatin C(Cys C),and neutrophil gelatinase-associated lipocalin(NGAL),were detected and calculated in both groups before and in 72 h after PCI.The incidence of CIN was recorded in the two groups,and logistic regression analysis was used to determine the effect of dapagliflozin on the occurrence of CIN.The occurrence of major adverse cardiac events(MACE)was observed in the two groups during follow-up period,and Kaplan-Meier curve analysis and Log-rank test were applied to com-pare the differences in the occurrence.Results There were no significant differences in the general clinical data between the two groups(P＞0.05).Serum levels of Cys C,β2-MG,and NGAL were increased in both groups in 72 h after PCI,with these levels obviously lower in the dapagliflozin group than the control group(P＜0.05,P＜0.01).The dapagliflozin group experienced a lower incidence of CIN than the control group(4.7％vs 12.2％,P=0.035).Logistic regression analysis indicated that dapagliflozin was an independent protective factor for CIN(OR=0.256,95％CI:0.083-0.796,P=0.019).In a follow-up period of 14.25±2.15 months,a lower incidence rate of MACE was observed in the dapagliflozin group than the control group(Log rank x2=5.257,P=0.022;HR=0.460,95％CI:0.237-0.893).Conclusion Dapagliflozin may reduce the occurrence of CIN and MACE in elderly patients with T2DM after PCI.
Keywords：diabetes mellitustype 2percutaneous coronary interventionprognosiscontrast-induced nephropathymajor adverse cardiac eventsdapagliflozin
Publication Date：2024-06-15
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：5( 632-636 )