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Effect of continuous use of metformin on kidney function in diabetes patients with acute myocardial infarction undergoing primary percutaneous coronary intervention
Diabetes patients presenting with ST-segment elevation myocardial infarction (STEMI) scheduled for primary percutaneous coronary intervention (PCI) have an increased risk of contrast induced-acute kidney injury (CI-AKI). The effects of continuous use of metformin on kidney function are still controv...
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Published in: | BMC cardiovascular disorders 2020-04, Vol.20 (1), p.187-9, Article 187 |
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description | Diabetes patients presenting with ST-segment elevation myocardial infarction (STEMI) scheduled for primary percutaneous coronary intervention (PCI) have an increased risk of contrast induced-acute kidney injury (CI-AKI). The effects of continuous use of metformin on kidney function are still controversial in patients submitted to primary PCI. This study aimed to assess continuous metformin therapy on kidney function in diabetic patients undergoing coronary intervention.
Two hundred eighty-four patients with metformin-treated diabetes, who underwent coronary intervention within 24 h for STEMI, were enrolled in the retrospective study. All the patients had estimated glomerular filtration rate (eGFR) of > 30 mL/min/1.73 m
. According to the physicians' decisions after admission, 119 patients continued metformin treatment after primary PCI, while 165 patients discontinued it > 48 h after the procedure. Serum creatinine was collected at admission and within 48 h post primary PCI to evaluate the incidence of CI-AKI. We performed a multiple logistic regression analysis to examine the determinants of CI-AKI.
No statistical difference in CI-AKI incidence between the continuous and the discontinuous metformin group (12.6%vs10.3%, p = 0.545). Multivariable logistic regression analysis indicated eGFR ≤60 ml/min/1.73 m
[p = 0.025, OR: 3.131; 95% CI (1.156-8.482)] and contrast volume [p = 0.002, OR: 1.010; 95% CI (1.004-1.016)] were predictive factors of CI-AKI. Metformin therapy was irrelevant to CI-AKI [p = 0.365, OR: 0.698; 95% CI (0.320-1.521)]. No case of lactic acidosis was found in this study. Besides, the study supported discontinuation of metformin was not beneficial for patients' blood glucose control after admission.
The study indicated that the metformin continuation after primary PCI for STEMI in diabetic patients with eGFR > 30 ml/min / 1.73 m
did not increase the risk of CI-AKI. |
doi_str_mv | 10.1186/s12872-020-01474-5 |
format | article |
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Two hundred eighty-four patients with metformin-treated diabetes, who underwent coronary intervention within 24 h for STEMI, were enrolled in the retrospective study. All the patients had estimated glomerular filtration rate (eGFR) of > 30 mL/min/1.73 m
. According to the physicians' decisions after admission, 119 patients continued metformin treatment after primary PCI, while 165 patients discontinued it > 48 h after the procedure. Serum creatinine was collected at admission and within 48 h post primary PCI to evaluate the incidence of CI-AKI. We performed a multiple logistic regression analysis to examine the determinants of CI-AKI.
No statistical difference in CI-AKI incidence between the continuous and the discontinuous metformin group (12.6%vs10.3%, p = 0.545). Multivariable logistic regression analysis indicated eGFR ≤60 ml/min/1.73 m
[p = 0.025, OR: 3.131; 95% CI (1.156-8.482)] and contrast volume [p = 0.002, OR: 1.010; 95% CI (1.004-1.016)] were predictive factors of CI-AKI. Metformin therapy was irrelevant to CI-AKI [p = 0.365, OR: 0.698; 95% CI (0.320-1.521)]. No case of lactic acidosis was found in this study. Besides, the study supported discontinuation of metformin was not beneficial for patients' blood glucose control after admission.
The study indicated that the metformin continuation after primary PCI for STEMI in diabetic patients with eGFR > 30 ml/min / 1.73 m
did not increase the risk of CI-AKI.</description><identifier>ISSN: 1471-2261</identifier><identifier>EISSN: 1471-2261</identifier><identifier>DOI: 10.1186/s12872-020-01474-5</identifier><identifier>PMID: 32316910</identifier><language>eng</language><publisher>England: BioMed Central Ltd</publisher><subject>Acidosis ; Angioplasty ; Antidiabetics ; Cardiovascular disease ; Contrast agents ; Contrast induced-acute kidney injury ; Coronary vessels ; Creatinine ; Data collection ; Diabetes ; Diabetes mellitus ; Diabetics ; Dosage and administration ; Drug therapy ; Epidermal growth factor receptors ; Fasting ; Glomerular filtration rate ; Glucose ; Health aspects ; Heart attack ; Heart attacks ; Hemoglobin ; Hospitals ; Insulin ; Kidney ; Kidneys ; Laboratories ; Lactic acidosis ; Medical imaging ; Metformin ; Mortality ; Myocardial infarction ; Patient outcomes ; Patients ; Regression analysis ; Risk factors ; ST-segment elevation myocardial infarction ; Studies ; Variables</subject><ispartof>BMC cardiovascular disorders, 2020-04, Vol.20 (1), p.187-9, Article 187</ispartof><rights>COPYRIGHT 2020 BioMed Central Ltd.</rights><rights>2020. This work is licensed under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>The Author(s) 2020</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c563t-6d28a9b8c63111b1dd6a89fcf9833269552166821c08d53e333a2905ab1e8d323</citedby><cites>FETCH-LOGICAL-c563t-6d28a9b8c63111b1dd6a89fcf9833269552166821c08d53e333a2905ab1e8d323</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7175536/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.proquest.com/docview/2404258160?pq-origsite=primo$$EHTML$$P50$$Gproquest$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,885,25753,27924,27925,37012,44590,53791,53793</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32316910$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Yu, Qi</creatorcontrib><creatorcontrib>Zhu, Jia-Jia</creatorcontrib><creatorcontrib>Liu, Wen-Xian</creatorcontrib><title>Effect of continuous use of metformin on kidney function in diabetes patients with acute myocardial infarction undergoing primary percutaneous coronary intervention</title><title>BMC cardiovascular disorders</title><addtitle>BMC Cardiovasc Disord</addtitle><description>Diabetes patients presenting with ST-segment elevation myocardial infarction (STEMI) scheduled for primary percutaneous coronary intervention (PCI) have an increased risk of contrast induced-acute kidney injury (CI-AKI). The effects of continuous use of metformin on kidney function are still controversial in patients submitted to primary PCI. This study aimed to assess continuous metformin therapy on kidney function in diabetic patients undergoing coronary intervention.
Two hundred eighty-four patients with metformin-treated diabetes, who underwent coronary intervention within 24 h for STEMI, were enrolled in the retrospective study. All the patients had estimated glomerular filtration rate (eGFR) of > 30 mL/min/1.73 m
. According to the physicians' decisions after admission, 119 patients continued metformin treatment after primary PCI, while 165 patients discontinued it > 48 h after the procedure. Serum creatinine was collected at admission and within 48 h post primary PCI to evaluate the incidence of CI-AKI. We performed a multiple logistic regression analysis to examine the determinants of CI-AKI.
No statistical difference in CI-AKI incidence between the continuous and the discontinuous metformin group (12.6%vs10.3%, p = 0.545). Multivariable logistic regression analysis indicated eGFR ≤60 ml/min/1.73 m
[p = 0.025, OR: 3.131; 95% CI (1.156-8.482)] and contrast volume [p = 0.002, OR: 1.010; 95% CI (1.004-1.016)] were predictive factors of CI-AKI. Metformin therapy was irrelevant to CI-AKI [p = 0.365, OR: 0.698; 95% CI (0.320-1.521)]. No case of lactic acidosis was found in this study. Besides, the study supported discontinuation of metformin was not beneficial for patients' blood glucose control after admission.
The study indicated that the metformin continuation after primary PCI for STEMI in diabetic patients with eGFR > 30 ml/min / 1.73 m
did not increase the risk of CI-AKI.</description><subject>Acidosis</subject><subject>Angioplasty</subject><subject>Antidiabetics</subject><subject>Cardiovascular disease</subject><subject>Contrast agents</subject><subject>Contrast induced-acute kidney injury</subject><subject>Coronary vessels</subject><subject>Creatinine</subject><subject>Data collection</subject><subject>Diabetes</subject><subject>Diabetes mellitus</subject><subject>Diabetics</subject><subject>Dosage and administration</subject><subject>Drug therapy</subject><subject>Epidermal growth factor receptors</subject><subject>Fasting</subject><subject>Glomerular filtration rate</subject><subject>Glucose</subject><subject>Health aspects</subject><subject>Heart attack</subject><subject>Heart attacks</subject><subject>Hemoglobin</subject><subject>Hospitals</subject><subject>Insulin</subject><subject>Kidney</subject><subject>Kidneys</subject><subject>Laboratories</subject><subject>Lactic acidosis</subject><subject>Medical imaging</subject><subject>Metformin</subject><subject>Mortality</subject><subject>Myocardial infarction</subject><subject>Patient outcomes</subject><subject>Patients</subject><subject>Regression analysis</subject><subject>Risk factors</subject><subject>ST-segment elevation myocardial infarction</subject><subject>Studies</subject><subject>Variables</subject><issn>1471-2261</issn><issn>1471-2261</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>PIMPY</sourceid><sourceid>DOA</sourceid><recordid>eNptUstu1DAUjRCIloEfYIEssU7xI3acDVJVFahUiQ2sLcePqYeJPdhO0fwPH8qdZigdCXlh-_iecx8-TfOW4AtCpPhQCJU9bTHFLSZd37X8WXMOB9JSKsjzJ-ez5lUpG4xJL_HwsjljlBExEHze_L723pmKkkcmxRrinOaC5uIOyOSqT3kKEaWIfgQb3R75OZoa4A6oDXp01RW00zW4WAv6Feod0mauDk37ZHSGkC2Eep0X1hyty-sU4hrtcph03qOdy0DQ0R0ym5RTPKAhVpfvQRRYr5sXXm-Le3PcV833T9ffrr60t18_31xd3raGC1ZbYanUwyiNYISQkVgrtBy88YNkjIqBc0qEkJQYLC1njjGm6YC5HomTFmayam4WXZv0Rh3rU0kH9QCkvFY612C2TuluYJb0lnk2dIPn0mspnSGea0jtO9D6uGjt5nFy1kAnWW9PRE9fYrhT63SvetJzzgQIvD8K5PRzdqWqTZpzhP4V7XBHuSQC_4taa6gKBp1AzEyhGHUpaM84pdDmqrn4TxQs66YA_-58APyEQBeCyamU7Pxj4QSrg_nUYj4F5lMP5lMcSO-etvxI-es29gdod9iV</recordid><startdate>20200421</startdate><enddate>20200421</enddate><creator>Yu, Qi</creator><creator>Zhu, Jia-Jia</creator><creator>Liu, Wen-Xian</creator><general>BioMed Central Ltd</general><general>BioMed Central</general><general>BMC</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QP</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>5PM</scope><scope>DOA</scope></search><sort><creationdate>20200421</creationdate><title>Effect of continuous use of metformin on kidney function in diabetes patients with acute myocardial infarction undergoing primary percutaneous coronary intervention</title><author>Yu, Qi ; Zhu, Jia-Jia ; Liu, Wen-Xian</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c563t-6d28a9b8c63111b1dd6a89fcf9833269552166821c08d53e333a2905ab1e8d323</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Acidosis</topic><topic>Angioplasty</topic><topic>Antidiabetics</topic><topic>Cardiovascular disease</topic><topic>Contrast agents</topic><topic>Contrast induced-acute kidney injury</topic><topic>Coronary vessels</topic><topic>Creatinine</topic><topic>Data collection</topic><topic>Diabetes</topic><topic>Diabetes mellitus</topic><topic>Diabetics</topic><topic>Dosage and administration</topic><topic>Drug therapy</topic><topic>Epidermal growth factor receptors</topic><topic>Fasting</topic><topic>Glomerular filtration rate</topic><topic>Glucose</topic><topic>Health aspects</topic><topic>Heart attack</topic><topic>Heart attacks</topic><topic>Hemoglobin</topic><topic>Hospitals</topic><topic>Insulin</topic><topic>Kidney</topic><topic>Kidneys</topic><topic>Laboratories</topic><topic>Lactic acidosis</topic><topic>Medical imaging</topic><topic>Metformin</topic><topic>Mortality</topic><topic>Myocardial infarction</topic><topic>Patient outcomes</topic><topic>Patients</topic><topic>Regression analysis</topic><topic>Risk factors</topic><topic>ST-segment elevation myocardial infarction</topic><topic>Studies</topic><topic>Variables</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Yu, Qi</creatorcontrib><creatorcontrib>Zhu, Jia-Jia</creatorcontrib><creatorcontrib>Liu, Wen-Xian</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Publicly Available Content Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>BMC cardiovascular disorders</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Yu, Qi</au><au>Zhu, Jia-Jia</au><au>Liu, Wen-Xian</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Effect of continuous use of metformin on kidney function in diabetes patients with acute myocardial infarction undergoing primary percutaneous coronary intervention</atitle><jtitle>BMC cardiovascular disorders</jtitle><addtitle>BMC Cardiovasc Disord</addtitle><date>2020-04-21</date><risdate>2020</risdate><volume>20</volume><issue>1</issue><spage>187</spage><epage>9</epage><pages>187-9</pages><artnum>187</artnum><issn>1471-2261</issn><eissn>1471-2261</eissn><abstract>Diabetes patients presenting with ST-segment elevation myocardial infarction (STEMI) scheduled for primary percutaneous coronary intervention (PCI) have an increased risk of contrast induced-acute kidney injury (CI-AKI). The effects of continuous use of metformin on kidney function are still controversial in patients submitted to primary PCI. This study aimed to assess continuous metformin therapy on kidney function in diabetic patients undergoing coronary intervention.
Two hundred eighty-four patients with metformin-treated diabetes, who underwent coronary intervention within 24 h for STEMI, were enrolled in the retrospective study. All the patients had estimated glomerular filtration rate (eGFR) of > 30 mL/min/1.73 m
. According to the physicians' decisions after admission, 119 patients continued metformin treatment after primary PCI, while 165 patients discontinued it > 48 h after the procedure. Serum creatinine was collected at admission and within 48 h post primary PCI to evaluate the incidence of CI-AKI. We performed a multiple logistic regression analysis to examine the determinants of CI-AKI.
No statistical difference in CI-AKI incidence between the continuous and the discontinuous metformin group (12.6%vs10.3%, p = 0.545). Multivariable logistic regression analysis indicated eGFR ≤60 ml/min/1.73 m
[p = 0.025, OR: 3.131; 95% CI (1.156-8.482)] and contrast volume [p = 0.002, OR: 1.010; 95% CI (1.004-1.016)] were predictive factors of CI-AKI. Metformin therapy was irrelevant to CI-AKI [p = 0.365, OR: 0.698; 95% CI (0.320-1.521)]. No case of lactic acidosis was found in this study. Besides, the study supported discontinuation of metformin was not beneficial for patients' blood glucose control after admission.
The study indicated that the metformin continuation after primary PCI for STEMI in diabetic patients with eGFR > 30 ml/min / 1.73 m
did not increase the risk of CI-AKI.</abstract><cop>England</cop><pub>BioMed Central Ltd</pub><pmid>32316910</pmid><doi>10.1186/s12872-020-01474-5</doi><tpages>9</tpages><oa>free_for_read</oa></addata></record> |
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subjects | Acidosis Angioplasty Antidiabetics Cardiovascular disease Contrast agents Contrast induced-acute kidney injury Coronary vessels Creatinine Data collection Diabetes Diabetes mellitus Diabetics Dosage and administration Drug therapy Epidermal growth factor receptors Fasting Glomerular filtration rate Glucose Health aspects Heart attack Heart attacks Hemoglobin Hospitals Insulin Kidney Kidneys Laboratories Lactic acidosis Medical imaging Metformin Mortality Myocardial infarction Patient outcomes Patients Regression analysis Risk factors ST-segment elevation myocardial infarction Studies Variables |
title | Effect of continuous use of metformin on kidney function in diabetes patients with acute myocardial infarction undergoing primary percutaneous coronary intervention |
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