Reviews in cardiovascular medicine · 2026
Impact of Sodium-Glucose Cotransporter 2 Inhibitors on Acute Kidney Injury Post Off-Pump Coronary Artery Bypass Grafting: A Retrospective Cohort Study and Meta-Analysis.
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Zhou Xiaozheng, Pan Yilin, Hua Kun, Yang Xiubin
Аннотация
BACKGROUND: Sodium-glucose cotransporter 2 (SGLT2) inhibitors, a novel class of oral antihyperglycemic medications prescribed for type 2 diabetes mellitus, play a beneficial role in slowing the progression of heart failure. However, debate persists regarding the potential link of these inhibitors to acute kidney injury (AKI) in specific clinical conditions.
METHODS: This study was a retrospective analysis of consecutive patients receiving off-pump coronary artery bypass grafting (OPCABG) at our institution between January 2018 and July 2023. A group of patients who had been administered SGLT2 inhibitors was systematically compared with non-users in a 1:3 ratio using propensity score matching. The principal endpoint was postoperative AKI after OPCABG. In addition, we performed a comprehensive meta-analysis of the associations between SGLT2 inhibitor therapy and AKI risk. The analytical approach combined institutional data with aggregated findings from existing literature.
RESULTS: The analysis encompassed 403 patients who administered SGLT2 inhibitors and 1209 non-users. AKI developed in 54 cases (13.4%) post-OPCABG among individuals who received SGLT2 inhibitors, compared to 373 cases (30.9%) in the control cohort. Statistical analysis demonstrated significantly reduced AKI prevalence in the SGLT2 inhibitor cohort compared to non-users (p < 0.001). The meta-analysis results confirmed a protective association between SGLT2 inhibitor therapy and AKI risk reduction (odds ratio (OR) = 0.525, 95% confidence interval (CI) 0.437-0.631; p < 0.001).
CONCLUSION: In this study, SGLT2 inhibitor administration was associated with a decreased incidence of postoperative AKI in OPCABG patients.
CLINICAL TRIAL REGISTRATION: NCT05888168, https://clinicaltrials.gov/study/NCT05888168?cond=NCT05888168&rank=1.
METHODS: This study was a retrospective analysis of consecutive patients receiving off-pump coronary artery bypass grafting (OPCABG) at our institution between January 2018 and July 2023. A group of patients who had been administered SGLT2 inhibitors was systematically compared with non-users in a 1:3 ratio using propensity score matching. The principal endpoint was postoperative AKI after OPCABG. In addition, we performed a comprehensive meta-analysis of the associations between SGLT2 inhibitor therapy and AKI risk. The analytical approach combined institutional data with aggregated findings from existing literature.
RESULTS: The analysis encompassed 403 patients who administered SGLT2 inhibitors and 1209 non-users. AKI developed in 54 cases (13.4%) post-OPCABG among individuals who received SGLT2 inhibitors, compared to 373 cases (30.9%) in the control cohort. Statistical analysis demonstrated significantly reduced AKI prevalence in the SGLT2 inhibitor cohort compared to non-users (p < 0.001). The meta-analysis results confirmed a protective association between SGLT2 inhibitor therapy and AKI risk reduction (odds ratio (OR) = 0.525, 95% confidence interval (CI) 0.437-0.631; p < 0.001).
CONCLUSION: In this study, SGLT2 inhibitor administration was associated with a decreased incidence of postoperative AKI in OPCABG patients.
CLINICAL TRIAL REGISTRATION: NCT05888168, https://clinicaltrials.gov/study/NCT05888168?cond=NCT05888168&rank=1.