Effect of dapagliflozin on contrast induced nephropathy after percutaneous coronary intervention in patients with hypertension and type 2 diabetes
Objective To investigate the effect of dapagliflozin on contrast induced nephropathy after percutaneous coronary intervention(PCI)in patients with hypertension and type 2 diabetes mellitus(T2DM).Methods The patients with hypertension and T2DM who underwent PCI in the Department of Cardiology,Tianjin University Chest Hospital from January 2021 to December 2023 were retrospectively selected.Patients were allocated into the dapagliflozin group and the control group using a 1∶1 propensity score matching method.The renal function of pa-tients from both groups,including parameters such as blood urea nitrogen(BUN),serum creatinine(Scr),creati-nine clearance rate(Ccr),blood β2 microglobulin(β2-MG),cystatin-C(Cys-C),blood neutrophil gelatinase-associ-ated lipocalin(NGAL),urinary NGAL,and urinary microalbumin(mALB),were documented before and 72 hours after PCI.The incidence of contrast induced nephropathy in both groups were recorded,and the effect of dapaglifloz-in on the occurrence of contrast induced nephropathy was evaluated using logistic regression analysis.The incidence of major adverse cardiovascular events(MACE)during follow-up was recorded in patients who had been followed up for at least 1 year.Results After propensity score matching,a total of 496 patients with hypertension and T2DM who underwent PCI were enrolled in the study,248 patients in the dapagliflozin group and 248 in the control group.Dapagliflozin was administered for an average duration of(7.02±2.60)weeks.At 72 hours after PCI,the levels of serum Cys-C,NGAL,β2-MG,urinary NGAL and mALB in the dapagliflozin group were significantly lower than those in the control group(all P＜0.05).The incidence of contrast induced nephropathy in the dapagliflozin group was lower than that in the control group(4.8％vs 10.1％,x2=4.936,P=0.039).Logistic regression analysis in-dicated that dapagliflozin was an independent protective factor of contrast induced nephropathy(OR=0.388,95％CI 0.175-0.858,P=0.019).During a median follow-up period of 15.2(12.0,16.8)months,the incidence of MACE in the dapagliflozin group was lower than that in the control group(Log-rank x2=3.884,P=0.049).Conclusion Dapagliflozin may reduce the incidence of contrast induced nephropathy and MACE in patients with hy-pertension and T2DM who underwent PCI,and may not increase the risk of acute kidney injury.
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