Relation of metformin treatment to clinical events in diabetic patients undergoing percutaneous intervention
Open accessAbstract
Diabetic patients undergoing coronary interventions have worse clinical and angiographic outcomes than do patients without diabetes. Metformin, an insulin sensitizer, may decrease the occurrence of these outcomes. Diabetic patients in the Prevention of Restenosis with Tranilast and its Outcomes Trial were identified through their medical records (n = 2,772). In this trial, 1,110 diabetic patients received nonsensitizer therapy (insulin and/or sulfonylureas) and 887 received sensitizer therapy (metformin with or without additional therapy). Logistic regression was used to obtain odds ratios (ORs) (sensitizer vs nonsensitizer therapy) of any clinical event (death, myocardial infarction, or ischemia-driven target vessel revascularization) and adjusted for multiple risk factors. Multivariate analysis showed no effect of lesion characteristics on clinical outcomes. Compared with patients on nonsensitizer therapy, those on sensitizer therapy showed an adjusted OR of 0.72 (95% confidence interval [CI] 0.57 to 0.91, p = 0.005) for any clinical event. The differences between the nonsensitizer therapy group and the sensitizer group were attributable mainly to decreased rates of death (OR 0.39, 95% CI 0.19 to 0.77, p = 0.007) and myocardial infarction (OR 0.31, 95% CI 0.15 to 0.66, p = 0.002). In our retrospective analysis, use of metformin in diabetics undergoing coronary interventions appeared to decrease adverse clinical events, especially death and myocardial infarction, compared with diabetic patients treated with nonsensitizer therapy.
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The PRESTO trial showed significant reductions of any clinical event (28%), myocardial infarction (69%), and all-cause mortality (61%).
“The PRESTO trial showed significant reductions of any clinical event (28%), myocardial infarction (69%), and all-cause mortality (61%) [74].”
From Metformin: An Old But Still the Best Treatment for Type 2 Diabetes (2013) · cites this paper as [74]
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- Authors
- Kao, J., Tobis, J., McClelland, R. L., Heaton, M. R., Davis, B. R., Holmes, D. R., & Currier, J. W.
- Affiliations
- University of California, Los Angeles (US)
- Mayo Clinic (US)
- Corresponding author
- Currier, Jesse W
- Venue
- The American Journal of Cardiology
- Publisher
- Elsevier BV
- Published
- 2004-06
- Volume
- 93
- Issue
- 11
- Pages
- 1347-1350
- ISSN
- 0002-9149 (ISSN-L)
- OpenAlex
- W2041244642
- Cited by
- 93
- References
- 18
- Citations by year
- 2026: 1 · 2024: 2 · 2023: 2 · 2022: 3 · 2021: 2 · 2020: 2 · 2019: 2 · 2018: 2 · 2017: 6 · 2016: 5 · 2015: 6 · 2014: 7 · 2013: 7 · 2012: 2
- FWCI
- 7.27
- Type
- journal article
- Language
- en
- Open access
- green
- escholarship.org
- Licence
- Locations
- The American Journal of Cardiology (publishedVersion)
- PubMed (publishedVersion)
- eScholarship (California Digital Library) (submittedVersion, cc-by)
- Topics
- Health Sciences › Medicine › Surgery › Coronary Interventions and Diagnostics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Antiplatelet Therapy and Cardiovascular Diseases
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Keywords
- metformin, diabetes mellitus, coronary intervention, percutaneous coronary intervention, insulin sensitizers, clinical outcomes, myocardial infarction, mortality, restenosis, sulfonylureas, insulin therapy
- MeSH terms
- Diabetes Mellitus, Diabetic Angiopathies, Female, Humans, Hypoglycemic Agents, Male, Metformin, Middle Aged, Myocardial Infarction, Platelet Aggregation Inhibitors, Retrospective Studies, Angioplasty, Balloon, Coronary, Logistic Models, Proportional Hazards Models, Case-Control Studies, Randomized Controlled Trials as Topic, Databases, Factual, Coronary Restenosis, Diabetes Complications, ortho-Aminobenzoates
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