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This pilot randomized controlled trial aims to evaluate the feasibility for safety examination of continued metformin therapy in patients with type 2 diabetes (T2D) following invasive coronary angiography. Metformin will be continued until coronary angiography.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Metformin Continuation | Experimental | Patients undergoing angiography will continue their metformin without interruption at their next scheduled dose following angiography. |
|
| Metformin Interruption | No Intervention | Patients undergoing angiography will interrupt their metformin for 48 hours post angiography. |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Metformin | Drug | Continuation of Metformin |
|
| Measure | Description | Time Frame |
|---|---|---|
| Lactic Acidosis | Lactate Level >5 mmol/L and HCO3<18 | 48-72 hours (or 72 hours for patients with staged PCI procedures within 48 hours of randomization) |
| Measure | Description | Time Frame |
|---|---|---|
| Acute Kidney Injury | Rise in baseline creatinine >/= 25% or 27 umol/L | 48-72 hours (or 72 hours for patients with staged PCI procedures within 48 hours of randomization) |
| All cause mortality at hospital discharge |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Jay Shavadia, MD | Contact | 3066553932 | jss372@usask.ca |
| Name | Affiliation | Role |
|---|---|---|
| Jay Shavadia, MD | University of Saskatchewan, Department of Medicine, Division of Cardiology | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Royal University Hospital | Recruiting | Saskatoon | Saskatchewan | S7N0W8 | Canada |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 20393934 | Background | Salpeter SR, Greyber E, Pasternak GA, Salpeter EE. Risk of fatal and nonfatal lactic acidosis with metformin use in type 2 diabetes mellitus. Cochrane Database Syst Rev. 2010 Apr 14;2010(4):CD002967. doi: 10.1002/14651858.CD002967.pub4. | |
| 9441244 | Background | Misbin RI, Green L, Stadel BV, Gueriguian JL, Gubbi A, Fleming GA. Lactic acidosis in patients with diabetes treated with metformin. N Engl J Med. 1998 Jan 22;338(4):265-6. doi: 10.1056/NEJM199801223380415. No abstract available. |
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| ID | Term |
|---|---|
| D054058 | Acute Coronary Syndrome |
| D000789 | Angina, Unstable |
| D003920 | Diabetes Mellitus |
| ID | Term |
|---|---|
| D017202 | Myocardial Ischemia |
| D006331 | Heart Diseases |
| D002318 | Cardiovascular Diseases |
| D014652 | Vascular Diseases |
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| ID | Term |
|---|---|
| D008687 | Metformin |
| ID | Term |
|---|---|
| D001645 | Biguanides |
| D006146 | Guanidines |
| D000578 | Amidines |
| D009930 | Organic Chemicals |
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Randomized Controlled Trial
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Death in hospital
| Duration of hospital admission |
| 29111980 | Background | Oktay V, Calpar Cirali I, Sinan UY, Yildiz A, Ersanli MK. Impact of continuation of metformin prior to elective coronary angiography on acute contrast nephropathy in patients with normal or mildly impaired renal functions. Anatol J Cardiol. 2017 Nov;18(5):334-339. doi: 10.14744/AnatolJCardiol.2017.7836. Epub 2017 Oct 31. |
| 27376570 | Background | Zeller M, Labalette-Bart M, Juliard JM, Potier L, Feldman LJ, Steg PG, Cottin Y, Roussel R. Metformin and contrast-induced acute kidney injury in diabetic patients treated with primary percutaneous coronary intervention for ST segment elevation myocardial infarction: Amulticenter study. Int J Cardiol. 2016 Oct 1;220:137-42. doi: 10.1016/j.ijcard.2016.06.076. Epub 2016 Jun 23. |
| 21959259 | Background | Maznyczka A, Myat A, Gershlick A. Discontinuation of metformin in the setting of coronary angiography: clinical uncertainty amongst physicians reflecting a poor evidence base. EuroIntervention. 2012 Jan;7(9):1103-10. doi: 10.4244/EIJV7I9A175. |
| D000787 |
| Angina Pectoris |
| D002637 | Chest Pain |
| D010146 | Pain |
| D009461 | Neurologic Manifestations |
| D012816 | Signs and Symptoms |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D044882 | Glucose Metabolism Disorders |
| D008659 | Metabolic Diseases |
| D009750 | Nutritional and Metabolic Diseases |
| D004700 | Endocrine System Diseases |