Impact of SGLT2-inhibitors on acute kidney injury in diabetic patients with severe aortic stenosis undergoing transcatheter aortic valve implantation (TAVI)

作者：Pasquale Paolisso, Marta Belmonte, Emanuele Gallinoro, Roberto Scarsini, Luca Bergamaschi, Leonardo Portolan, Matteo Armillotta, Giuseppe Esposito, Elisabetta Moscarella, Claudio Montalto, Elayne Kelen de Oliveira, Francesco Angeli, Mateusz Orzałkiewicz, Margherita Fabroni, Verdiana Galli, Nurcan Baydaroglu, Francesca Di Lenarda, Pasquale Policastro, Carlo Terrone, Davide Ausiello, Giose Vincelli, Matteo Casenghi, Lucia Scisciola, Raffaele Marfella, Felice Gragnano, Edoardo Conte, Dario Pellegrini, Alfonso Ielasi, Daniele Andreini, Jacopo Oreglia, Paolo Calabrò, Antonio L. Bartorelli, Tullio Palmerini, Francesco Saia, Flavio Ribichini, Michelangela Barbieri, Marc Vanderheyden, Carmine Pizzi, Emanuele Barbato · 发表于：Cardiovascular Diabetology · 年份：2025 · DOI：10.1186/s12933-025-02773-x · 被引用次数：19 · 研究领域：Diabetes Treatment and Management、Cardiac Valve Diseases and Treatments、Hyperglycemia and glycemic control in critically ill and hospitalized patients

BACKGROUND: Acute kidney injury (AKI) following transcatheter aortic valve implantation (TAVI) is associated with significantly worse outcomes, leading to increased short- and long-term mortality. We sought to evaluate the impact of sodium-glucose cotransporter 2 inhibitors (SGLT2i) on the risk of AKI in patients with type 2 diabetes mellitus (T2DM) and severe aortic stenosis (AS) undergoing TAVI. METHODS: Multicenter international registry of consecutive T2DM patients with severe AS undergoing TAVI between 2021 and 2024. The study population was stratified by the presence of chronic kidney disease (CKD), defined according to the KDIGO guideline, and anti-diabetic therapy at hospital admission (SGLT2i versus no-SGLT2i users). AKI was defined according to the Valve Academy Research Consortium 3 (VARC-3) criteria. RESULTS: The study population consisted of 514 patients stratified into those without CKD (n = 226, 44%), of whom 43 (19%) were treated with SGLT2i, and 288 (56%) with CKD, of whom 71 (24.7%) were on SGLT2i treatment. The median age was 81 [77-84] years, and 60.1% were males. SGLT2i use did not impact renal function in patients without CKD, with AKI occurring in 7.1% of the cases, regardless of SGLT2i use. Among CKD patients, AKI occurred more frequently in no-SGLT2i users compared to those receiving SGLT2i (19.8% versus 8.5%, p = 0.027), with a significant increase in post-TAVI and discharge serum creatinine values for no-SGLT2i users (p = 0.001 after TAVI and p < 0....