Photo Credit: Ekaterina Chizhevskaya
The following is a summary of “Effects of Novel Antidiabetic Agents on Contrast-Associated Acute Kidney Injury in Diabetic Patients Undergoing Percutaneous Coronary Intervention,” published in the January 2025 issue of Cardiology by Nusca et al.
Contrast-associated acute kidney injury (CA-AKI) remains a complication following percutaneous coronary revascularization (PCI), particularly challenging in patients with diabetes due to limited effective preventive strategies.
Researchers conducted a retrospective study to assess the effects of novel antidiabetic agents (NAD), including glucagon-like peptide-1 receptor agonists (GLP-1RAs), sodium-glucose transporter-2 inhibitors (SGLT2i), and dipeptidyl peptidase-4 inhibitors (DPP4i), on the occurrence of CA-AKI in patients with diabetes undergoing PCI.
They enrolled 293 patients with diabetes receiving NAD during PCI, (NAD group) and matched them with 293 individuals with diabetes undergoing revascularization without NAD (no-NAD group) based on age and sex. The CA-AKI was defined as an increase in serum creatinine (SCr) ≥0.3 mg/dl or >50% from baseline within 48-72 hours after contrast exposure. A propensity score-adjusted logistic regression analysis was used to control for potential selection bias.
The results showed that NAD treatment was linked to a significantly lower incidence of CA-AKI compared to standard glucose-lowering therapies (4.1% vs 8.5%, P =0.023). Patients using SGLT2i and GLP-1RAs had a lower CA-AKI incidence than those using DPP4i. Multivariate and propensity-score-adjusted regression analyses identified NAD therapy as an independent predictor of CA-AKI (OR 0.45, 95% CI 0.22-0.98, P =0.040 and OR 0.48, 95% CI 0.23-0.98, P =0.045).
Investigators concluded the potential benefit of all 3 NAD classes on CA-AKI incidence, with the use of these agents linked to a lower renal damage incidence in patients with diabetes undergoing PCI, particularly for SGLT2i and GLP-1RAs.
Source: ajconline.org/article/S0002-9149(25)00015-3/abstract
