The Protective Effect of Dapagliflozin Against Contrast-Induced Nephropathy After Percutaneous Coronary Catheterization in Patients Moderate to High-Risk for CIN
Keywords:
Contrast-induced nephropathy; Dapagliflozin; Cardiac catheterization.Abstract
Background: Dapagliflozin may have a reno-protective effect on patients with chronic renal disease. Additionally, there is mounting evidence that it can reduce the incidence of contrast-induced nephropathy (CIN) and protect against acute renal injury.
Objective: To assess the role of dapagliflozin in the prevention of CIN in patients with moderate to high risk for CIN who are undergoing cardiac catheterization and PCI.
Patients and Methods: Two subgroups of 200 moderate-to-high-risk CIN patients who received percutaneous coronary intervention (PCI) were created: Group A: Included patients who were already on dapagliflozin 10mg before undergoing cardiac catheterization and PCI and Group B: Included patients who weren't on dapagliflozin. Every patient underwent a thorough history taking, physical examination, echocardiogram, twelve-lead ECG, routine laboratory tests and evaluation of their Mehran risk score.
Results: The incidence of CIN was higher in Group B according to the KDIGO definition (22% vs. 41%, p 0.002), and higher post-intervention S. creatinine (1.54±0.4 vs 1.8±0.52, p 0.03). Hemoglobin levels were significantly lower in CIN cases of Group B compared to Group A (11.42±1.95 vs. 13.6±1.35 g/dL, p=0.006). Patients with CIN had significantly higher HbA1c levels (mean 10.35±1.05 vs. 7.97±0.84, p < 0.001) and higher Mehran risk scores (mean 9.36±1.71 vs. 7.13±1.42, p < 0.001). Statin use was significantly less common among CIN cases (36.36% vs. 98.72%, p < 0.001). Multivariate logistic regression analysis revealed that the odds ratio of HbA1c was 47.889, with a significant logistic regression relationship between the two variables (p=0.004). Odds ratio of Mehran score was 6.254, with a significant logistic regression relationship between the two variables (p=0.029).
Conclusion: Dapagliflozin may have a protective effect in patients with moderate to high risk for developing CIN, especially in complex interventions with high contrast volume.
