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Metformin Myocardial Infarction

Metformin To Reduce Heart Failure After Myocardial Infarction (gips-iii)

Metformin To Reduce Heart Failure After Myocardial Infarction (gips-iii)

Improvement in Left Ventricular Ejection Fraction [TimeFrame:4 months] The primary efficacy parameter of the GIPS-III trial is LVEF measured by cardiac MRI 4 months after randomization, based on an intention-to-treat analysis. It is hypothesized that metformin therapy will result in a higher ejection fraction after 4 months. the Incidence of a Cardiovascular Event [TimeFrame:4 months and longterm follow-up] Cardiovascular events include major cardiac adverse events (MACE; death, recurrent MI, target lesion revascularization), stroke, non-elective hospitalizations for chest pain or heart failure, all recurrent coronary interventions, and internal cardiac defibrillator implantations. Mortality will be divided into cardiac and non-cardiac. Cardiac death will be divided into three categories: heart failure, sudden death and other. A cardiologist will confirm deaths from cardiovascular causes by examining medical records obtained from hospitals and attending physicians or from attending general practitioner if the patient died at home. Markers of Heart Failure and Glycometabolic State [TimeFrame:4 months and longterm follow-up] markers of heart failure: neurohormones (e.g. NT-proBNP), renal function (e.g. MDRD); glycometabolic state: e.g. HbA1c. Myocardial Infarct Size and Transmural Extent of Infarction as Measured With Cardiac Magnetic Resonance Imaging [TimeFrame:4 months after hospitalization] myocardial infarct size and transmural extent of infarction will be measured using Late Gadolinium Enhancement cardiac magnetic imaging Diastolic Function [TimeFrame:4 months] echocardiographic analysis of diastolic function Glycometabolic State [TimeFrame:4 months and long-term follow-up] measured by oral glucose tolerance testing and Glycated Hemoglobin according to current crit Continue reading >>

Fenofibrate Plus Metformin Produces Cardioprotection In A Type 2 Diabetes And Acute Myocardial Infarction Model

Fenofibrate Plus Metformin Produces Cardioprotection In A Type 2 Diabetes And Acute Myocardial Infarction Model

Fenofibrate plus Metformin Produces Cardioprotection in a Type 2 Diabetes and Acute Myocardial Infarction Model Vctor Hugo Oidor-Chan ,1,2 Enrique Hong ,1 Francisca Prez-Severiano ,3 Sergio Montes ,3 Juan Carlos Torres-Narvez ,2 Leonardo del Valle-Mondragn ,2 Gustavo Pasteln-Hernndez ,2and Alicia Snchez-Mendoza 2 1Department of Pharmacobiology, Research and Advanced Studies Center, National Polytechnic Institute (IPN), Calzada de los Tenorios No. 235, Colonia Granjas Coapa, Tlalpan, 14330 Mexico City, Mexico 2Department of Pharmacology, National Institute of Cardiology Ignacio Chvez, Juan Badiano No. 1, Colonia Seccin XVI, Tlalpan, 14080 Mexico City, Mexico 3Department of Neurochemistry, National Institute of Neurology and Neurosurgery Manuel Velasco Surez, Insurgentes Sur No. 3877, Colonia La Fama, Tlalpan, 14269 Mexico City, Mexico Received 7 January 2016; Accepted 18 February 2016 Copyright 2016 Vctor Hugo Oidor-Chan et al. This is an open access article distributed under the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. We investigated whether fenofibrate, metformin, and their combination generate cardioprotection in a rat model of type 2 diabetes (T2D) and acute myocardial infarction (AMI). Streptozotocin-induced diabetic- (DB-) rats received 14 days of either vehicle, fenofibrate, metformin, or their combination and immediately after underwent myocardial ischemia/reperfusion (I/R). Fenofibrate plus metformin generated cardioprotection in a DBI/R model, reported as decreased coronary vascular resistance, compared to DBI/R-Vehicle, smaller infarct size, and increased cardiac work. The subchronic treatment with fenofibrate plus metformin increased, co Continue reading >>

Effect Of Metformin On Metabolites And Relation With Myocardial Infarct Size And Left Ventricular Ejection Fraction After Myocardial Infarction

Effect Of Metformin On Metabolites And Relation With Myocardial Infarct Size And Left Ventricular Ejection Fraction After Myocardial Infarction

Effect of Metformin on Metabolites and Relation With Myocardial Infarct Size and Left Ventricular Ejection Fraction After Myocardial Infarction Effect of Metformin on Metabolites and Relation With Myocardial Infarct Size and Left Ventricular Ejection Fraction After Myocardial Infarction Eppinga, Ruben N; Kofink, Daniel; Dullaart, Robin P F; Dalmeijer, Geertje W; Lipsic, Erik; van Veldhuisen, Dirk J; van der Horst, Iwan C C; Asselbergs, Folkert W; van der Harst, Pim (2017) Circulation-Cardiovascular genetics, volume 10, issue 1 BACKGROUND: Left ventricular ejection fraction (LVEF) and infarct size (ISZ) are key predictors of long-term survival after myocardial infarction (MI). However, little is known about the biochemical pathways driving LV dysfunction after MI. To identify novel biomarkers predicting post-MI LVEF and ISZ, we performed metabolic profiling in the GIPS-III randomized ... read more clinical trial (Glycometabolic Intervention as Adjunct to Primary Percutaneous Intervention in ST Elevation Myocardial Infarction). We also investigated the metabolic footprint of metformin, a drug associated with improved post-MI LV function in experimental studies. METHODS AND RESULTS: Participants were patients with ST-segment-elevated MI who were randomly assigned to receive metformin or placebo for 4 months. Blood samples were obtained on admission, 24 hours post-MI, and 4 months post-MI. A total of 233 metabolite measures were quantified using nuclear magnetic resonance spectrometry. LVEF and ISZ were assessed 4 months post-MI. Twenty-four hours post-MI measurements of high-density lipoprotein (HDL) triglycerides (HDL-TG) predicted LVEF (=1.90 [95% confidence interval (CI), 0.82 to 2.98]; P=6.410(-4)) and ISZ (=-0.41 [95% CI, -0.60 to -0.21]; P=3.210(-5)). In addition, 2 Continue reading >>

Gips-iii Trial: Diabetes Drug Metformin No Benefit In Stemi

Gips-iii Trial: Diabetes Drug Metformin No Benefit In Stemi

GIPS-III Trial: Diabetes Drug Metformin No Benefit in STEMI WASHINGTON, DC The diabetes drug metformin was of no benefit when given to patients without diabetes who had just suffered an ST-segment acute MI (STEMI), a new study illustrates. The results of the Glycometabolic Intervention as Adjunct to Primary Percutaneous Coronary Intervention in ST-Segment Elevation Myocardial Infarction (GIPS-III) study were presented during a late-breaking clinical-trial session at the American College of Cardiology 2014 Scientific Sessions earlier this week by Chris P.H. Lexis, MD, of University Medical Center Groningen, the Netherlands. They were also published simultaneously in the Journal of the American Medical Association. "In patients without diabetes, metformin 500 mg twice a day, started directly after percutaneous coronary intervention [PCI] and continued for 4 months, does not preserve left ventricular ejection fraction [LVEF] after STEMI compared with placebo," Dr. Lexis told the conference. "The current results do not support the use of metformin in this setting," he added, although he noted that the findings indicate that use of this hypoglycemic agent "was safe" in this patient population. No Difference in LVEF, pro-BNP Between Arms in GIPS-III Dr. Lexis explained that although timely reperfusion can reduce myocardial damage and the risk for left ventricular (LV) dysfunction in STEMI, the latter can still occur in up to 50% of patients. Of patients with STEMI, 20% to 40% will consequently develop heart failure, which is associated with a 3- to 4-fold higher risk for death; 1 in 7 people with acute MI "will die from the consequences," he observed. The idea that metformin, the most widely used hypoglycemic agent in the world, might have favorable effects on ventricular fu Continue reading >>

Drugs For Diabetes: Part 1 Metformin

Drugs For Diabetes: Part 1 Metformin

This website is intended for UK healthcare professionals only Log in | Register September 2010Br J Cardiol 2010;17:2314 Leave a comment Authors: James G Boyle, Gerard A McKay, Miles Fisher Royal Alexandra Hospital, Paisley, PA2 9PN. University Medical Unit, Glasgow Royal Infirmary, Glasgow, G4 0SF. Metformin is one of the oldest oral treatments to reduce hyperglycaemia in people with diabetes. Gastrointestinal side effects are common, and metformin should be used with caution in patients with renal impairment because of the slight risk of lactic acidosis. In the United Kingdom Prospective Diabetes Study (UKPDS) patients treated with metformin had a significant reduction in myocardial infarction and mortality that was not demonstrated in patients treated with sulphonylureas or insulin. The fact that metformin significantly reduces cardiovascular events plus reduces weight has meant that metformin is the drug of first choice in guidelines for the treatment of type 2 diabetes. There are no longer concerns about using metformin in patients with chronic heart failure, other than in patients with associated renal failure, or during episodes of acute left ventricular failure when metformin should be temporarily stopped. The BJC is introducing a small charge for some of its premium content. On purchase you will receive an email to access the article and have a downloadable PDF to keep. The PDF can be downloaded from a button on the sidebar. Please note the purchase of this article is for your personal use only.By supporting us in this way, you are helping us to deliver high-quality services to healthcare professionals. We will continue to keep the majority of our content free of charge. You can access this article without logging in.But don't miss out on the many Benefits of o Continue reading >>

(pdf) Effect Of Metformin On Left Ventricular Function After Acute Myocardial Infarction In Patients Without Diabetes The Gips-iii Randomized Clinical Trial

(pdf) Effect Of Metformin On Left Ventricular Function After Acute Myocardial Infarction In Patients Without Diabetes The Gips-iii Randomized Clinical Trial

All content in this area was uploaded by Rudolf Allert de Boer on Dec 19, 2014 Copyright 2014 American Medical Association. All rights reserved. Effect of Metformin on Left Ventricular Function After Acute Myocardial Infarction in Patients Without Diabetes Chris P. H. Lexis, MD; Iwan C. C. van der Horst, MD, PhD; Erik Lipsic, MD, PhD; Wouter G. Wieringa, MD; Rudolf A. de Boer, MD, PhD; Ad F. M. vanden Heuvel, MD, PhD; Hindrik W. van der Werf, MD; Remco A. J. Schurer, MD; Gabija Pundziute, MD, PhD; Eng S. Tan, MD, PhD; Wybe Nieuwland, MD, PhD; Hendrik M. Willemsen, MD; Bernard Dorhout, PhD; Barbara H. W. Molmans, PharmD; Anouk N. A. van der Horst-Schrivers, MD, PhD; Bruce H. R. Wolffenbuttel, MD, PhD; Gert J. ter Horst, PhD; Albert C. van Rossum, MD, PhD; Jan G. P. Tijssen, PhD; Hans L. Hillege, MD, PhD; Bart J. G. L. de Smet, MD, PhD; Pim van der Harst, MD, PhD; Dirk J.van Veldhuisen, MD, PhD; IMPORTANCE Metformin treatment is associated with improved outcome after myocardial infarction in patients with diabetes. In animal experimental studies metformin preserves left OBJECTIVE To evaluate the effect of metformin treatment on preservation of left ventricular function in patients without diabetes presenting with ST-segment elevation myocardial DESIGN, SETTING, AND PARTICIPANTS Double-blind, placebo-controlled study conducted among 380 patients who underwent primary percutaneous coronary intervention (PCI) for STEMI at the University Medical Center Groningen, the Netherlands, between January 1, 2011, INTERVENTIONS Metformin hydrochloride (500 mg) (n = 191) or placebo (n = 189) twice daily MAIN OUTCOMES AND MEASURES The primary efficacy measure was left ventricular ejection fraction (LVEF) after 4 months, assessed by magnetic resonance imaging. A secondary efficacy measur Continue reading >>

Metformin-associated Lactic Acidosis Presenting As Acute St-elevation Myocardial Infarction - Sciencedirect

Metformin-associated Lactic Acidosis Presenting As Acute St-elevation Myocardial Infarction - Sciencedirect

Metformin-Associated Lactic Acidosis Presenting as Acute ST-Elevation Myocardial Infarction Metformin-associated lactic acidosis (MALA) is a rare but life-threatening adverse drug reaction of metformin, the most frequently prescribed medication for patients with type 2 diabetes mellitus. The diagnosis of MALA is difficult to make because of diverse clinical presentations that can masquerade as other critical illnesses. A 52-year-old woman presented with altered mental status, hypoglycemia, and shock. A prehospital electrocardiogram showed findings consistent with posterolateral ST-elevation myocardial infarction, and the cardiac catheterization laboratory was activated before patient arrival. On arrival to the emergency department, she was found to have severe metabolic derangements and hypothermia, and the catheterization laboratory was canceled. Aggressive supportive measures and emergent hemodialysis were instituted. A metformin concentration was sent from the ED and returned at 51g/mL (therapeutic range 12g/mL), making MALA the most likely diagnosis. She recovered after prolonged critical illness and was discharged in good condition. No alternate diagnoses were found despite extensive work-up. Why Should An Emergency Physician Be Aware of This? Metformin is the most prescribed antidiabetic drug in the world. Although MALA is a rare complication, it is important for emergency physicians to keep MALA on the differential for diabetic patients presenting with severe metabolic acidosis. Continue reading >>

Possibility For The Metformin Administration In Post-infarction Period In Patients With The 2-nd Type Of Dm

Possibility For The Metformin Administration In Post-infarction Period In Patients With The 2-nd Type Of Dm

Possibility for the Metformin administration in post-infarction period in patients with the 2-nd type of DM Natallia Yaroshevich, Anastasiya Hlazkova, Larissa Danilova, Irina Burko & Anastasiya Hlazkova Belarussian Medical Academy of Post-Graduate Education, Minsk, Belarus. In our study during the period of 6 months we were monitoring lactate and other biochemical parameters levels in patients with diabetes mellitus and myocardial infarction after introducing Metformin into their treatment protocols. Fifteen persons with the DM 2 (eight males and seven females) were included into the first group. Metformin was administrated in a daily dosage of 1700 mg. Some patients (7/15) were receiving antidiabetic therapy with the sulphonyl urea of the second generation - Gliclazide in the dosage from 60 to 120 mg/day. Second control group has been formed by 19 patients with DM 2 (11 males and 8 females), after myocardial infarction, receiving only Gliclazide, without Metformin. On each visit we evaluated the body weight, waist and hip measurements, contamination of the visceral fat (%), blood pressure, fasting glycemia, HbA1c, Total Cholesterol (TC), triglycerides (TG), cholesterol of the lipoproteins of low density (LDLP), cholesterol of the lipoproteins of high density (HDLP) and basal insulinemia level (IRI). Insulin resistance index - Homeostasis model assessment (HOMAIR) has been calculated according to standard formula. Results: i) During the administration of Metformin to the complex therapy of the patients with DM2 in post infarction period we did not registered any case of lactate of creatinine elevation for the duration of the whole follow-up period. ii) Myocardial infarction except the acute phase cannot be considered as contraindication to Metformin administration. iii Continue reading >>

Contraindications To The Use Of Metformin

Contraindications To The Use Of Metformin

Contraindications to the use of metformin Evidence suggests that it is time to amend the list Department of Diabetes, Gartnavel General Hospital, Glasgow G12 0YN Copyright 2003, BMJ Publishing Group Ltd This article has been cited by other articles in PMC. According to the United Kingdom prospective diabetes study, patients with type 2 diabetes randomised to intensive treatment with metformin, sulphonylurea, or insulin had similar degrees of glycaemic control and significantly reduced microvascular end points. 1 The study showed that the use of metformin in obese patients reduced cardiovascular events. The group treated with metformin had no hypoglycaemia and less weight gain. Treatment with metformin rather than diet alone produced a significant reduction in relative risk in all cause mortality (36%, P=0.011), diabetes related deaths (42%, P=0.017), any diabetes related end point (32%, P=0.0023), and myocardial infarction (39%, P=0.01). Metformin is the only oral hypoglycaemic agent proved to reduce cardiovascular risk and is now recognised as the treatment of choice in overweight patients with type 2 diabetes. Lactic acidosis associated with metformin is a rare condition with an estimated prevalence of one to five cases per 100 000. 2 Although classically lactic acidosis associated with metformin has been thought of as lactic acidosis secondary to accumulation of metformin, the evidence for this is poor. Metformin does not affect lactate concentrations in patients with type 2 diabetes, 3 is excreted solely through the kidney, and has a short half lifeaccumulation of metformin therefore rarely occurs in the absence of advanced renal failure. 4 Accumulation of metformin alone is rarely reported as a cause of lactic acidosis, and tissue hypoxia acting as a trigger is fo Continue reading >>

Chronic Metformin Treatment Is Associated With Reduced Myocardial Infarct Size In Diabetic Patients With St-segment Elevation Myocardial Infarction

Chronic Metformin Treatment Is Associated With Reduced Myocardial Infarct Size In Diabetic Patients With St-segment Elevation Myocardial Infarction

Chronic Metformin Treatment is Associated with Reduced Myocardial Infarct Size in Diabetic Patients with ST-segment Elevation Myocardial Infarction Lexis, C. P. H., Wieringa, W. G., Hiemstra, B., van Deursen, V. M., Lipsic, E., van der Harst, P., van Veldhuisen, D. J. & van der Horst, I. C. C. Apr-2014 In : Cardiovascular Drugs and Therapy. 28, 2, p. 163-171 9 p. Research output: Scientific - peer-review Article Lexis, C. P. H., Wieringa, W. G., Hiemstra, B., van Deursen, V. M., Lipsic, E., van der Harst, P., ... van der Horst, I. C. C. (2014). Chronic Metformin Treatment is Associated with Reduced Myocardial Infarct Size in Diabetic Patients with ST-segment Elevation Myocardial Infarction. Cardiovascular Drugs and Therapy, 28(2), 163-171. DOI: 10.1007/s10557-013-6504-7 Lexis, Chris P. H. ; Wieringa, Wouter G. ; Hiemstra, Bart ; van Deursen, Vincent M. ; Lipsic, Erik ; van der Harst, Pim ; van Veldhuisen, Dirk J. ; van der Horst, Iwan C. C./ Chronic Metformin Treatment is Associated with Reduced Myocardial Infarct Size in Diabetic Patients with ST-segment Elevation Myocardial Infarction. In: Cardiovascular Drugs and Therapy. 2014 ; Vol. 28, No. 2. pp. 163-171 Lexis, CPH, Wieringa, WG, Hiemstra, B, van Deursen, VM, Lipsic, E, van der Harst, P, van Veldhuisen, DJ & van der Horst, ICC 2014, 'Chronic Metformin Treatment is Associated with Reduced Myocardial Infarct Size in Diabetic Patients with ST-segment Elevation Myocardial Infarction' Cardiovascular Drugs and Therapy, vol 28, no. 2, pp. 163-171. DOI: 10.1007/s10557-013-6504-7 Chronic Metformin Treatment is Associated with Reduced Myocardial Infarct Size in Diabetic Patients with ST-segment Elevation Myocardial Infarction. / Lexis, Chris P. H.; Wieringa, Wouter G.; Hiemstra, Bart; van Deursen, Vincent M.; Lipsic, Erik; Continue reading >>

Metformin Plays Role In Reducing Mi, Heart Failure Risk

Metformin Plays Role In Reducing Mi, Heart Failure Risk

Metformin plays role in reducing MI, heart failure risk NASHVILLE, Tenn. Even slight weight effects associated with metformin use may reduce risk for myocardial infarction and heart failure, according to a presenter here. We dont know how metformin works, but I would speculate that suppression of appetite and promotion of weight loss may play a role, John M. Miles, MD, professor of medicine at the University of Kansas in Kansas City, said during a presentation at the AACE 24th Annual Scientific & Clinical Congress. According to Miles, metformins role in reducing MI was established in the original United Kingdom Prospective Diabetes Study, which found a nearly one-third reduction in MI in patients assigned metformin compared with a nonsignificant reduction among those assigned insulin plus a sulfonylurea. In the 20-year follow-up study, the two groups saw a nearly identical effect on HbA1c, but the insulin plus sulfonylurea group showed a 15% reduction in MI while the metformin group had a statinesque 39% event reduction, Miles said. What was dramatically different [between the study groups] was body weight, which was greater than control in the sulfonylurea-insulin group, but not greater than control in the metformin group, Miles said. Modest intentional weight loss of just a few pounds is associated with longer life in people with type 2 diabetes. Miles cited studies showing an association between metformin use and lower risk for heart failure as well. In contrast, other studies suggested an increased risk for heart failure and elevated blood pressure with insulin use. If your patient gains 7 kg or 8 kg, should you be surprised that their BP might go up? he asked. Miles also said metformin use could safely be expanded to patients with stage 3 kidney disease. Evidence Continue reading >>

The Effect Of Metformin On Diastolic Function In Patients Presenting With St-elevation Myocardial Infarction

The Effect Of Metformin On Diastolic Function In Patients Presenting With St-elevation Myocardial Infarction

The Effect of Metformin on Diastolic Function in Patients Presenting with ST-Elevation Myocardial Infarction Affiliation Department of Cardiology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands Affiliation Department of Cardiology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands Affiliation Department of Cardiology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands Affiliation Department of Cardiology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands Affiliation Department of Cardiology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands Affiliation Department of Cardiology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands Affiliation Department of Cardiology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands Affiliation Department of Cardiology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands Affiliation Department of Critical Care, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands Affiliation Department of Cardiology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands The Effect of Metformin on Diastolic Function in Patients Presenting with ST-Elevation Myocardial Infarction Diastolic dysfunction is an important predictor of poor outcome after myocardial infarction. Metformin treatment improved diastolic function in animal models and patients with diabetes. Whether metformin improves diastolic function in patients presenting with ST-segment elevation myocardial infarction (STEM Continue reading >>

Metformin And Myocardial Injury In Patients With Diabetes And Stsegment Elevation Myocardial Infarction: A Propensity Score Matched Analysis

Metformin And Myocardial Injury In Patients With Diabetes And Stsegment Elevation Myocardial Infarction: A Propensity Score Matched Analysis

Metformin and Myocardial Injury in Patients With Diabetes and STSegment Elevation Myocardial Infarction: A Propensity Score Matched Analysis 3Department of Cardiology, North ShoreLIJ Health System, Manhasset, NY 4Nassau University Medical Center, East Meadow, NY 3Department of Cardiology, North ShoreLIJ Health System, Manhasset, NY 4Nassau University Medical Center, East Meadow, NY 1Department of Critical Care Medicine, Valley Health System, Winchester, VA 2Department of Medicine, North ShoreLIJ Health System, Great Neck, NY 3Department of Cardiology, North ShoreLIJ Health System, Manhasset, NY 4Nassau University Medical Center, East Meadow, NY 5Biostatistics Unit, The Feinstein Institute for Medical Research, North ShoreLIJ Health System, Manhasset, NY 6Department of Geriatrics, North ShoreLIJ Health System, New Hyde Park, NY *Correspondence to: Andrzej Kozikowski, PhD, Department of Medicine, North ShoreLIJ Health System, 175 Community Drive, Second Floor, Great Neck, NY 11021. Email: ude.shsn@ikswokizoka Received 2015 Jun 19; Accepted 2015 Sep 21. Copyright 2015 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell. This is an open access article under the terms of the Creative Commons AttributionNonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes. This article has been cited by other articles in PMC. Although animal studies have documented metformin's cardioprotective effects, the impact in humans remains elusive. The study objective was to explore the association between metformin and myocardial infarct size in patients with diabetes presenting with STsegment elevation myocardial infarction. Data extraction Continue reading >>

Acc: Metformin No Help In Mi Recovery

Acc: Metformin No Help In Mi Recovery

For best viewing, click the bottom right corner for full screen. Click here for more ACC 2014 video coverage. by Crystal Phend Crystal Phend, Senior Staff Writer, MedPage Today This article is a collaboration between MedPage Today and: WASHINGTON -- Metformin started soon after reperfusion in the acute setting didn't help cardiac function recover in non-diabetic heart attack patients, a trial showed. Left ventricular ejection fraction was no different with a 4-month course of the drug started immediately after percutaneous intervention for acute ST-segment myocardial infarction (STEMI) than with placebo (53% versus 55% of predicted, P=0.096). N-terminal pro-brain natriuretic peptide (NT-proBNP) as a marker of cardiac stress came out at an identical 167 ng/L in both groups at that point, Chris Lexis, MD, of University Medical Center Groningen, the Netherlands, and colleagues found. "The current results do not support use of metformin in this setting ," Lexis concluded here at the American College of Cardiology meeting and simultaneously online in the Journal of the American Medical Association. That wasn't surprising, Howard Weintraub, MD , of NYU Langone Medical Center in New York City, told MedPage Today. "They gave this to a non-diabetic group," he said "So we're asking the question are there mystical properties, are there properties that beyond the range of what the drug is supposed to do, so-called pleiotropic properties that we've attributed with statins and ACE inhibitors and ARBs." However, there was at least no signal of harm, Amit Khera, MD , of the University of Texas Southwestern Medical Center in Dallas, noted in discussing the trial at a press conference. There were no cases of severe renal impairment or lactic acidosis and no difference between groups in Continue reading >>

Effect Of Metformin On Left Ventricular Function After Acute Myocardial Infarction In Patients Without Diabetesthe Gips-iii Randomized Clinical Trial

Effect Of Metformin On Left Ventricular Function After Acute Myocardial Infarction In Patients Without Diabetesthe Gips-iii Randomized Clinical Trial

Steg PG, James SK, Atar D, et al; Task Force on the management of ST-segment elevation acute myocardial infarction of the European Society of Cardiology (ESC). ESC Guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation.Eur Heart J. 2012;33(20):2569-2619. PubMed Google Scholar Crossref OGara PT, Kushner FG, Ascheim DD, et al; American College of Emergency Physicians; Society for Cardiovascular Angiography and Interventions. 2013 ACCF/AHA guideline for the management of ST-elevation myocardial infarction: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines.J Am Coll Cardiol. 2013;61(4):e78-e140. PubMed Google Scholar Crossref Patel MR, Dehmer GJ, Hirshfeld JW, Smith PK, Spertus JA. ACCF/SCAI/STS/AATS/AHA/ASNC 2009 Appropriateness Criteria for Coronary Revascularization: a report of the American College of Cardiology Foundation Appropriateness Criteria Task Force, Society for Cardiovascular Angiography and Interventions, Society of Thoracic Surgeons, American Association for Thoracic Surgery, American Heart Association, and the American Society of Nuclear Cardiology: endorsed by the American Society of Echocardiography, the Heart Failure Society of America, and the Society of Cardiovascular Computed Tomography.Circulation. 2009;119(9):1330-1352. PubMed Google Scholar Crossref Hirsch A, Nijveldt R, van der Vleuten PA, et al; HEBE Investigators. Intracoronary infusion of mononuclear cells from bone marrow or peripheral blood compared with standard therapy in patients after acute myocardial infarction treated by primary percutaneous coronary intervention: results of the randomized controlled HEBE trial.Eur Heart J. 2011;32(14):1736-1747. PubMed Google Sch Continue reading >>

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