Association of SGLT2 inhibitor dapagliflozin with risks of acute kidney injury and all-cause mortality in acute myocardial infarction patients.

Objective: Sodium-glucose cotransporter 2 (SGLT2) inhibitors have well-documented effects in reducing hospitalization or cardiovascular mortality, while the association of SGLT2 inhibitor dapagliflozin (DAPA) and the risk of acute kidney injury (AKI) in acute myocardial infarction (AMI) patients has...

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Publicado en:European Journal of Clinical Pharmacology Vol. 80; no. 4; pp. 613 - 621
Autores principales: Cai, Dabei, Chen, Qianwen, Mao, Lipeng, Xiao, Tingting, Wang, Yu, Gu, Qingqing, Wang, Qingjie, Ji, Yuan, Sun, Ling
Formato: research Journal Article
Publicado: Springer Nature Apr2024
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Apr2024
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      pub: Springer Nature
      place: New York, New York
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        10.1007/s00228-024-03623-7
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        atl: Association of SGLT2 inhibitor dapagliflozin with risks of acute kidney injury and all-cause mortality in acute myocardial infarction patients.
      aug:
        au:
          Cai, Dabei
          Chen, Qianwen
          Mao, Lipeng
          Xiao, Tingting
          Wang, Yu
          Gu, Qingqing
          Wang, Qingjie
          Ji, Yuan
          Sun, Ling
        affil: https://ror.org/01xncyx73 Department of Cardiology, the Affiliated Changzhou Second People's Hospital of Nanjing Medical University, 213000, Changzhou, Jiangsu, China
      sug:
        subj:
          Myocardial Infarction Drug Therapy
          Myocardial Infarction Mortality
          Cause of Death
          Sodium-Glucose Co-Transporter 2 Inhibitors Adverse Effects
          Dapagliflozin Adverse Effects
          Kidney Failure, Acute Risk Factors
          Risk Assessment
          Kidney Failure, Acute Chemically Induced
          Percutaneous Coronary Intervention Adverse Effects
          Human
          Registries, Disease
          Retrospective Design
          Record Review
          Odds Ratio
          Outcome Assessment
          Univariate Statistics
          Multivariate Analysis
          Multiple Logistic Regression
          Descriptive Statistics
          Postoperative Complications
          Confidence Intervals
      ab: Objective: Sodium-glucose cotransporter 2 (SGLT2) inhibitors have well-documented effects in reducing hospitalization or cardiovascular mortality, while the association of SGLT2 inhibitor dapagliflozin (DAPA) and the risk of acute kidney injury (AKI) in acute myocardial infarction (AMI) patients has not been comprehensively investigated. Therefore, we aimed to assess the association between DAPA and AKI risk in AMI patients after percutaneous coronary intervention (PCI) therapy. Methods: Using the Changzhou Acute Myocardial Infarction Registry database, we retrospectively included AMI patients from January 2017 to August 2021 and analyzed the risk of AKI and all-cause mortality after PCI therapy. The patients were divided into two groups according to the use of DAPA (DAPA group and Ctrl group). Patients in the DAPA group started to use DAPA after admission and continued its use during hospitalization and follow-up period. Baseline characteristics were balanced between the two groups with a propensity score matching (PSM) analysis. The outcome was AKI within 7 days after PCI and all-cause mortality during a follow-up of 2 years. Univariate and multivariate logistic regression analyses were used to assess the association between DAPA and AKI risk. Results: A total of 1839 AMI patients undergoing PCI were enrolled. DAPA was used in 278 (15.1%) patients. Postoperative AKI occurred in 351 (19.1%) cases. A 1:1 PSM analysis was used to reduce confounding factors. The multivariate stepwise regression analysis showed that DAPA (odds ratio, OR 0.66; 95% confidence interval, CI 0.44–0.97; P = 0.036) was an independent protective factor in the entire cohort. After matching, the use of DAPA in AMI patients was independently associated with a decline of AKI risk (OR 0.32; 95% CI, 0.19–0.53; P < 0.001) after hospital admission. Meanwhile, there were significant differences in mortality between the DAPA group and Ctrl group (2.5% vs. 7.6%, P = 0.012). Conclusion: SGLT2 inhibitor DAPA was associated with lower risks of incident AKI and all-cause mortality in AMI patients after PCI therapy.
      pubtype: Academic Journal
      doctype:
        research
        Journal Article
      ougenre: Article
    language: English
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