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.
Zhou et al. (Wed,) studied this question.