Effects of GLP-1 receptor agonists on the incidence of contrast-induced acute kidney injury in patients with Type 2 diabetes mellitus undergoing coronary interventions.
Contrast-induced acute kidney injury (CI-AKI) is a frequent complication of coronary angiography and percutaneous coronary intervention (PCI), particularly in patients with type 2 diabetes mellitus (T2DM). Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) may exert renoprotective effects, but evidence in the setting of contrast exposure remains limited.
To evaluate the association between GLP-1 RA therapy and CI-AKI in patients with T2DM undergoing coronary angiography or PCI for acute coronary syndromes.
This retrospective cohort study included 336 patients with T2DM who underwent coronary angiography or PCI between May 2023 and March 2025. Patients receiving stable GLP-1 RA therapy (n=149) were compared with non-users (n=187). Serum creatinine and estimated glomerular filtration rate (eGFR) were measured at baseline and 48-72 hours after the procedure. CI-AKI was defined as a serum creatinine increase of ≥0.5 mg/dL or ≥25% from baseline within 72 hours. Multivariable logistic regression was used to identify independent predictors of CI-AKI.
CI-AKI occurred less frequently among GLP-1 RA users than non-users (8.7% vs 25.7%, p<0.001). At 48-72 hours, eGFR was higher in the GLP-1 RA group (67.1 ± 12.1 vs 58.0 ± 11.8 mL/min/1.73 m², p<0.001), whereas serum creatinine did not differ significantly (1.02 ± 0.73 vs 1.17 ± 1.57 mg/dL, p=0.084). GLP-1 RA use was independently associated with lower odds of CI-AKI (OR 0.290, 95% CI 0.119-0.708; p=0.007). Increasing age (OR 1.332, 95% CI 1.214-1.462; p<0.001) and ST-segment elevation myocardial infarction (OR 5.039, 95% CI 2.368-10.722; p<0.001) were associated with higher odds, whereas higher baseline eGFR was associated with lower odds (OR 0.919, 95% CI 0.862-0.979; p=0.009).
GLP-1 RA therapy was independently associated with a lower risk of CI-AKI in patients with T2DM undergoing contrast-based coronary procedures. These findings suggest a potential renoprotective association but require confirmation in prospective multicenter studies.
To evaluate the association between GLP-1 RA therapy and CI-AKI in patients with T2DM undergoing coronary angiography or PCI for acute coronary syndromes.
This retrospective cohort study included 336 patients with T2DM who underwent coronary angiography or PCI between May 2023 and March 2025. Patients receiving stable GLP-1 RA therapy (n=149) were compared with non-users (n=187). Serum creatinine and estimated glomerular filtration rate (eGFR) were measured at baseline and 48-72 hours after the procedure. CI-AKI was defined as a serum creatinine increase of ≥0.5 mg/dL or ≥25% from baseline within 72 hours. Multivariable logistic regression was used to identify independent predictors of CI-AKI.
CI-AKI occurred less frequently among GLP-1 RA users than non-users (8.7% vs 25.7%, p<0.001). At 48-72 hours, eGFR was higher in the GLP-1 RA group (67.1 ± 12.1 vs 58.0 ± 11.8 mL/min/1.73 m², p<0.001), whereas serum creatinine did not differ significantly (1.02 ± 0.73 vs 1.17 ± 1.57 mg/dL, p=0.084). GLP-1 RA use was independently associated with lower odds of CI-AKI (OR 0.290, 95% CI 0.119-0.708; p=0.007). Increasing age (OR 1.332, 95% CI 1.214-1.462; p<0.001) and ST-segment elevation myocardial infarction (OR 5.039, 95% CI 2.368-10.722; p<0.001) were associated with higher odds, whereas higher baseline eGFR was associated with lower odds (OR 0.919, 95% CI 0.862-0.979; p=0.009).
GLP-1 RA therapy was independently associated with a lower risk of CI-AKI in patients with T2DM undergoing contrast-based coronary procedures. These findings suggest a potential renoprotective association but require confirmation in prospective multicenter studies.