Metformin continuation before coronary angiography safe in diabetes patients
Italy: Metformin continuation throughout the periprocedural period in diabetes patients undergoing invasive coronary angiography did not increase lactate level or result in renal function decline, a recent study in Cardiovascular Diabetology has shown.
The findings suggest that suspending use of metformin before percutaneous coronary intervention (PCI) and coronary angiography is not necessary.
The study found that in diabetes patients without high-risk features for metformin accumulation, the continuation of metformin after and before coronary angiography without PCI led to similar preprocedural and 72-h lactate levels. CA-AKI risk was low; no patients needed hemodialysis during the index hospitalization or mid-term follow-up.
In diabetes patients, metformin is the most common hypoglycemic drug prescribed worldwide. Discontinuing metformin before invasive coronary angiography has become a common practice despite a lack of data; this is due to an alleged risk of Metformin-Associated Lactic Acidosis (M-ALA) and is usually limited to patients at increased metformin accumulation risk.
Against the above background, Mauro Chiarito from Humanitas University, Pieve Emanuele in Milan, Italy, and colleagues aimed to assess the safety of metformin continuation in patients with diabetes undergoing coronary angiography in terms of a significant increase in lactate levels in an open-label, prospective, multicentre, single-arm trial (NO-STOP).
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