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

Rene A Posma, Chris P H Lexis, Erik Lipsic, Maarten W N Nijsten, Kevin Damman, Daan J Touw, Dirk Jan van Veldhuisen, Pim van der Harst, Iwan C C van der Horst

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

PURPOSE: The association between metformin use and renal function needs further to be elucidated since data are insufficient whether metformin affects renal function in higher risk populations such as after ST-elevation myocardial infarction (STEMI).

METHODS: We studied 379 patients included in the GIPS-III trial in which patients without diabetes or renal dysfunction, who underwent primary percutaneous coronary interventions (PCI) for STEMI, were randomized to metformin 500 mg or placebo twice daily for four months. At baseline and at seven scheduled visits up to four months after PCI, estimated glomerular filtration rate (eGFR) was determined (2582 values). Contrast-induced acute kidney injury (CI-AKI) was defined as an increase in serum creatinine of ≥0.3 mg/dl or 25 % rise within 48 h after PCI.

RESULTS: At all visits, the mean eGFR was similar in patients randomized to metformin or placebo. Over the four month period, mixed-effect repeated-measures model analysis showed a least-squares mean ± standard error change in eGFR of -5.9±0.8 ml/min/1.73 m2 in the metformin group and −7.1 ±0.8 ml/min/1.73 m2 in the control group (P=0.27 for overall interaction). The incidence of CI-AKI was 14.8 %; 29 (15.2 %) patients in the metformin group versus 27 (14.4 %) controls (P=0.89). After adjustment for covariates, metformin treatment was not associated with CI-AKI (odds ratio: 0.96, 95%CI 0.52−1.75, P=0.88).

CONCLUSION: We conclude that initiation of metformin shortly after primary PCI has no adverse effect on renal function in patients without diabetes or prior renal impairment, further providing evidence of the safety of metformin use after myocardial infarction and subsequent contrast exposure.

Original languageEnglish
Pages (from-to)451-9
Number of pages9
JournalCardiovascular Drugs and Therapy
Volume29
Issue number5
DOIs
Publication statusPublished - 2015
Externally publishedYes

Keywords

  • Acute Kidney Injury/blood
  • Creatinine/blood
  • Diabetes Mellitus
  • Female
  • Glomerular Filtration Rate/drug effects
  • Humans
  • Hypoglycemic Agents/adverse effects
  • Kidney/drug effects
  • Male
  • Metformin/adverse effects
  • Middle Aged
  • Myocardial Infarction/complications
  • Percutaneous Coronary Intervention

Fingerprint

Dive into the research topics of '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'. Together they form a unique fingerprint.

Cite this