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 February 2025 issue of Cardiology by Nusca et al.

Contrast-associated acute kidney injury remains a significant complication following percutaneous coronary interventions (PCI), especially in patients with diabetes, with limited effective preventive strategies. This study aimed to evaluate the effects of novel antidiabetic agents, specifically glucagon-like peptide-1 receptor agonists, sodium-glucose transporter-2 inhibitors, and dipeptidyl peptidase-4 inhibitors, on the occurrence of CA-AKI in diabetic individuals undergoing PCI. 

A total of 293 consecutive patients with diabetes receiving NAD during PCI (NAD group) were matched with 293 patients with diabetes not on NAD (no-NAD group), with matching based on age and sex. CA-AKI was defined as an increase in serum creatinine (SCr) by ≥0.3 mg/dl or >50% from baseline within 48-72 hours after contrast exposure. Propensity score-adjusted logistic regression analysis was conducted to adjust for potential confounding variables. The results showed that NAD therapy was significantly associated with a lower incidence of CA-AKI compared to standard glucose-lowering treatments (4.1% vs 8.5%, P=0.023). 

Additionally, patients treated with SGLT2i and GLP-1RAs had a lower incidence of CA-AKI than those using DPP4i. Both multivariate and propensity score-adjusted analyses confirmed that NAD therapy was an independent predictor for a reduced risk 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, respectively). This study is the first to investigate the impact of all three NAD classes on CA-AKI incidence, showing that the use of these agents significantly reduces the occurrence of renal injury in patients with diabetes undergoing PCI. Notably, the most significant benefit was observed in patients using SGLT2i and GLP-1RAs.

Source: sciencedirect.com/science/article/abs/pii/S0002914925000153