Effect of Metformin on Renal Function After Primary Percutaneous Coronary Intervention in Patients Without Diabetes Presenting with ST-elevation Myocardial Infarction: Data from the GIPS-III Trial.

摘要: The association between metformin use and renal function needs further to be elucidated since data are insufficient whether affects in higher risk populations such as after ST-elevation myocardial infarction (STEMI). We studied 379 patients included the GIPS-III trial which without diabetes or dysfunction, who underwent primary percutaneous coronary interventions (PCI) for STEMI, were randomized 500 mg placebo twice daily four months. At baseline at seven scheduled visits up months PCI, estimated glomerular filtration rate (eGFR) was determined (2582 values). Contrast-induced acute kidney injury (CI-AKI) defined an increase serum creatinine of ≥0.3 mg/dl 25 % rise within 48 h PCI. all visits, mean eGFR similar placebo. Over month period, mixed-effect repeated-measures model analysis showed a least-squares ± standard error change -5.9 ± 0.8 ml/min/1.73 m2 group −7.1 ± 0.8 ml/min/1.73 m2 control (P = 0.27 overall interaction). incidence CI-AKI 14.8 %; 29 (15.2 %) versus 27 (14.4 %) controls (P = 0.89). After adjustment covariates, treatment not associated with (odds ratio: 0.96, 95%CI 0.52 − 1.75, P = 0.88). conclude that initiation shortly PCI has no adverse effect on prior impairment, providing evidence safety subsequent contrast exposure.