Two-year follow-up of 4 months metformin treatment vs. placebo in ST-elevation myocardial infarction

Autor: Iwan C. C. van der Horst, Pim van der Harst, Chris P. H. Lexis, Anouk N A van der Horst-Schrivers, Minke H. T. Hartman, Dirk J. van Veldhuisen, Jake K B Prins, Erik Lipsic, Remco A. J. Schurer
Přispěvatelé: Guided Treatment in Optimal Selected Cancer Patients (GUTS), Cardiovascular Centre (CVC), Critical care, Anesthesiology, Peri-operative and Emergency medicine (CAPE)
Jazyk: angličtina
Rok vydání: 2017
Předmět:
Male
Time Factors
medicine.medical_treatment
Administration
Ophthalmic
030204 cardiovascular system & hematology
law.invention
Electrocardiography
0302 clinical medicine
Randomized controlled trial
law
Medicine
030212 general & internal medicine
Myocardial infarction
Prospective Studies
REPERFUSION INJURY
METABOLIC SYNDROME
Hazard ratio
Diabetes
General Medicine
Middle Aged
RANDOMIZED CONTROLLED-TRIAL
Metformin
NONDIABETIC PATIENTS
ISCHEMIA
Treatment Outcome
Cardiology
HEART
Female
PERMEABILITY TRANSITION PORE
Cardiology and Cardiovascular Medicine
medicine.drug
medicine.medical_specialty
PERCUTANEOUS CORONARY INTERVENTION
Magnetic Resonance Imaging
Cine
Heart failure
Acute myocardial infarction
Placebo
03 medical and health sciences
CARDIOPROTECTION
Double-Blind Method
LEFT-VENTRICULAR FUNCTION
Diabetes mellitus
Internal medicine
Humans
Hypoglycemic Agents
cardiovascular diseases
Aged
Original Paper
Dose-Response Relationship
Drug
business.industry
Percutaneous coronary intervention
medicine.disease
ST Elevation Myocardial Infarction
business
Mace
Follow-Up Studies
Zdroj: Clinical Research in Cardiology
Clinical Research in Cardiology, 106(12), 939-946. SPRINGER HEIDELBERG
ISSN: 1861-0684
Popis: Objectives Preclinical and clinical studies suggested cardioprotective effects of metformin treatment. In the GIPS-III trial, 4 months of metformin treatment did not improve left ventricular ejection fraction in patients presenting with ST-elevation myocardial infarction (STEMI). Here, we report the 2-year follow-up results. Methods Between January 2011 and May 2013, 379 STEMI patients without diabetes undergoing primary percutaneous coronary intervention were randomized to a 4-month treatment with metformin (500 mg twice daily) (N = 191) or placebo (N = 188) in the University Medical Center Groningen. Two-year follow-up data was collected to determine its effect on predefined secondary endpoints: the incidence of major adverse cardiac events (MACE), its individual components, all-cause mortality, and new-onset diabetes. Results For all 379 patients all-cause mortality data were available. For seven patients (2%) follow-up data on MACE was limited, ranging from 129 to 577 days. All others completed the 2-year follow-up visit. Incidence of MACE was 11 (5.8%) in metformin and 6 (3.2%) in placebo treated patients [hazard ratio (HR) 1.84, confidence interval (CI) 0.68–4.97, P = 0.22]. Three patients died in the metformin group and one in the placebo treatment group. Individual components of MACE were also comparable between both groups. New-onset diabetes mellitus was 34 (17.8%) in metformin and 32 (17.0%) in placebo treated patients (odds ratio 1.15, CI 0.66–1.98, P = 0.84). After multivariable adjustment the incidence of MACE was comparable between the treatment groups (HR 1.02, CI 0.10–10.78, P = 0.99). Conclusions Four months metformin treatment initiated at the time of hospitalization in STEMI patients without diabetes did not exert beneficial long-term effects. Trial registration clinicaltrials.gov Identifier: NCT01217307. Electronic supplementary material The online version of this article (doi:10.1007/s00392-017-1140-z) contains supplementary material, which is available to authorized users.
Databáze: OpenAIRE
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