SGLT-2 inhibitors and prevention of contrast-induced nephropathy in patients with diabetes undergoing coronary angiography and percutaneous coronary interventions: systematic review and meta-analysis
IntroductionSGLT2 inhibitors (SGLT2Is) have demonstrated cardioprotective and nephroprotective effects in patients with and without diabetes. Recent studies suggest that SGLT2Is may reduce the risk of contrast-induced nephropathy (CIN) in patients with diabetes undergoing coronary arteriography (CAG...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2023-12-01
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| Series: | Frontiers in Endocrinology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fendo.2023.1307715/full |
| _version_ | 1797384878321303552 |
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| author | Edinson Dante Meregildo-Rodriguez Martha Genara Asmat-Rubio Gustavo Adolfo Vásquez-Tirado |
| author_facet | Edinson Dante Meregildo-Rodriguez Martha Genara Asmat-Rubio Gustavo Adolfo Vásquez-Tirado |
| author_sort | Edinson Dante Meregildo-Rodriguez |
| collection | DOAJ |
| description | IntroductionSGLT2 inhibitors (SGLT2Is) have demonstrated cardioprotective and nephroprotective effects in patients with and without diabetes. Recent studies suggest that SGLT2Is may reduce the risk of contrast-induced nephropathy (CIN) in patients with diabetes undergoing coronary arteriography (CAG) or percutaneous coronary interventions (PCI). However, the evidence is still inconclusive. We aimed to systematically review the evidence regarding the potential nephroprotective role of SGLT2Is in preventing CIN in this population.MethodsWe searched for studies in six databases published up to September 30, 2023, following a PECO/PICO strategy. Initially, we meta-analyzed five studies, but due to several reasons, mainly methodological concerns, we excluded one RCT. In our final meta-analysis, we included four observational studies.ResultsThis meta-analysis comprised 2,572 patients with diabetes undergoing CAG or PCI, 512 patients treated with SGLT2Is, and 289 events of CIN. This is the first meta-analysis demonstrating that SGLT2Is may reduce the risk of developing CIN by up to 63% (RR 0.37; 95% CI 0.24–0.58) in patients with diabetes undergoing CAG or PCI, compared to not using SGLT2Is. Statistical heterogeneity was not significant (I2 = 0%, p = 0.91). We assessed the certainty of the evidence of this systematic review and meta-analysis, according to the GRADE criteria, as moderate.ConclusionSGLT2Is significantly reduce the risk of CIN by up to 63% in patients with diabetes undergoing CAG or PCI. Clinical trials are needed; several are already underway, which could confirm our findings and investigate other unresolved issues, such as the optimal dose, type, and duration of SGLT2 inhibitor therapy to prevent CIN.Systematic ReviewPROSPERO, identifier CRD42023412892. |
| first_indexed | 2024-03-08T21:45:53Z |
| format | Article |
| id | doaj.art-3b64ee3b944a418cb7ce28154efcb03f |
| institution | Directory Open Access Journal |
| issn | 1664-2392 |
| language | English |
| last_indexed | 2024-03-08T21:45:53Z |
| publishDate | 2023-12-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Endocrinology |
| spelling | doaj.art-3b64ee3b944a418cb7ce28154efcb03f2023-12-20T08:58:49ZengFrontiers Media S.A.Frontiers in Endocrinology1664-23922023-12-011410.3389/fendo.2023.13077151307715SGLT-2 inhibitors and prevention of contrast-induced nephropathy in patients with diabetes undergoing coronary angiography and percutaneous coronary interventions: systematic review and meta-analysisEdinson Dante Meregildo-Rodriguez0Martha Genara Asmat-Rubio1Gustavo Adolfo Vásquez-Tirado2Escuela de Medicina, Universidad César Vallejo, Trujillo, PeruEscuela de Posgrado, Universidad Privada Antenor Orrego, Trujillo, PeruEscuela de Medicina, Universidad Privada Antenor Orrego, Trujillo, PeruIntroductionSGLT2 inhibitors (SGLT2Is) have demonstrated cardioprotective and nephroprotective effects in patients with and without diabetes. Recent studies suggest that SGLT2Is may reduce the risk of contrast-induced nephropathy (CIN) in patients with diabetes undergoing coronary arteriography (CAG) or percutaneous coronary interventions (PCI). However, the evidence is still inconclusive. We aimed to systematically review the evidence regarding the potential nephroprotective role of SGLT2Is in preventing CIN in this population.MethodsWe searched for studies in six databases published up to September 30, 2023, following a PECO/PICO strategy. Initially, we meta-analyzed five studies, but due to several reasons, mainly methodological concerns, we excluded one RCT. In our final meta-analysis, we included four observational studies.ResultsThis meta-analysis comprised 2,572 patients with diabetes undergoing CAG or PCI, 512 patients treated with SGLT2Is, and 289 events of CIN. This is the first meta-analysis demonstrating that SGLT2Is may reduce the risk of developing CIN by up to 63% (RR 0.37; 95% CI 0.24–0.58) in patients with diabetes undergoing CAG or PCI, compared to not using SGLT2Is. Statistical heterogeneity was not significant (I2 = 0%, p = 0.91). We assessed the certainty of the evidence of this systematic review and meta-analysis, according to the GRADE criteria, as moderate.ConclusionSGLT2Is significantly reduce the risk of CIN by up to 63% in patients with diabetes undergoing CAG or PCI. Clinical trials are needed; several are already underway, which could confirm our findings and investigate other unresolved issues, such as the optimal dose, type, and duration of SGLT2 inhibitor therapy to prevent CIN.Systematic ReviewPROSPERO, identifier CRD42023412892. https://www.frontiersin.org/articles/10.3389/fendo.2023.1307715/fullsodium-glucose transporter 2 inhibitorsSGLT2 inhibitorsacute kidney injurycontrast-induced nephropathysystematic reviewmeta-analysis |
| spellingShingle | Edinson Dante Meregildo-Rodriguez Martha Genara Asmat-Rubio Gustavo Adolfo Vásquez-Tirado SGLT-2 inhibitors and prevention of contrast-induced nephropathy in patients with diabetes undergoing coronary angiography and percutaneous coronary interventions: systematic review and meta-analysis Frontiers in Endocrinology sodium-glucose transporter 2 inhibitors SGLT2 inhibitors acute kidney injury contrast-induced nephropathy systematic review meta-analysis |
| title | SGLT-2 inhibitors and prevention of contrast-induced nephropathy in patients with diabetes undergoing coronary angiography and percutaneous coronary interventions: systematic review and meta-analysis |
| title_full | SGLT-2 inhibitors and prevention of contrast-induced nephropathy in patients with diabetes undergoing coronary angiography and percutaneous coronary interventions: systematic review and meta-analysis |
| title_fullStr | SGLT-2 inhibitors and prevention of contrast-induced nephropathy in patients with diabetes undergoing coronary angiography and percutaneous coronary interventions: systematic review and meta-analysis |
| title_full_unstemmed | SGLT-2 inhibitors and prevention of contrast-induced nephropathy in patients with diabetes undergoing coronary angiography and percutaneous coronary interventions: systematic review and meta-analysis |
| title_short | SGLT-2 inhibitors and prevention of contrast-induced nephropathy in patients with diabetes undergoing coronary angiography and percutaneous coronary interventions: systematic review and meta-analysis |
| title_sort | sglt 2 inhibitors and prevention of contrast induced nephropathy in patients with diabetes undergoing coronary angiography and percutaneous coronary interventions systematic review and meta analysis |
| topic | sodium-glucose transporter 2 inhibitors SGLT2 inhibitors acute kidney injury contrast-induced nephropathy systematic review meta-analysis |
| url | https://www.frontiersin.org/articles/10.3389/fendo.2023.1307715/full |
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