Investigators tested whether an SGLT2 inhibitor would reduce postoperative AKI in a multicenter placebo-controlled trial.In patients undergoing elective cardiac surgery, four doses of dapagliflozin, beginning the day before surgery, reduced the incidence of AKI during the 7-day postoperative period.The trial was not powered to show whether perioperative dapagliflozin was of clinical benefit in reducing stage 3 AKI or major adverse cardiovascular events, however.
The risk of acute kidney injury (AKI) following elective cardiac surgery was largely reduced with a short course of SGLT2 inhibitor therapy, a Dutch trial found.
Initiation of once-daily dapagliflozin (Farxiga) 1 day prior to surgery was associated with a lower incidence of AKI at 7 days (28% vs 52% with placebo, relative risk 0.54, 95% CI 0.45-0.65), a finding that persisted after multivariable adjustment (OR 0.36, 95% CI 0.27-0.48).
The most frequent adverse events were atrial fibrillation, occurring in 45% of both groups, and reoperation, observed in 11% versus 10%, respectively, of the dapagliflozin and placebo groups, according to Abraham Hulst, MD, PhD, of Amsterdam University Medical Center, and colleagues of the MERCURI-2 trial published in JAMA.
