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The Effect of Metformin on Diastolic Function in Patients Presenting with ST-Elevation Myocardial Infarction
- Source :
- PLoS ONE, 11(12):e0168340. PUBLIC LIBRARY SCIENCE, PLoS ONE, Vol 11, Iss 12, p e0168340 (2016), PLoS ONE
- Publication Year :
- 2016
-
Abstract
- IntroductionDiastolic 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 (STEMI) is unknown.MethodsThe GIPS-III trial randomized STEMI patients, without known diabetes, to metformin or placebo initiated directly after PCI. The previously reported primary endpoint was left ventricular ejection fraction at 4 months, which was unaffected by metformin treatment. This is a predefined substudy to determine an effect of metformin on diastolic function. For this substudy trans-thoracic echocardiography was performed during hospitalization and after 4 months. Diastolic dysfunction was defined as having the combination of a functional alteration (i.e. decreased tissue velocity: mean of septal e' and lateral e') and a structural alteration (i.e. increased left atrial volume index (LAVI)). In addition, left ventricular mass index and transmitral flow velocity (E) to mean e' ratio (E/e') were measured to determine an effect of metformin on individual echocardiographic markers of diastolic function.ResultsIn 237 (63%) patients included in the GIPS-III trial diastolic function was measured during hospitalization as well as at 4 months. Diastolic dysfunction was present in 11 (9%) of patients on metformin and 11 (9%) patients on placebo treatment (P = 0.98) during hospitalization. After 4 months 22 (19%) of patients with metformin and 18 (15%) patients with placebo (P = 0.47) had diastolic dysfunction. In addition, metformin did not improve any of the individual echocardiographic markers of diastolic function.ConclusionsIn contrast to experimental and observational data, our randomized placebo controlled trial did not suggest a beneficial effect of short-term metformin treatment on diastolic function in STEMI patients.
- Subjects :
- Male
endocrine system diseases
Cardiovascular Procedures
Deceleration
medicine.medical_treatment
Myocardial Infarction
Placebo-controlled study
lcsh:Medicine
030204 cardiovascular system & hematology
Ventricular Function, Left
Diagnostic Radiology
Ventricular Dysfunction, Left
Endocrinology
Postoperative Complications
0302 clinical medicine
Diastole
Ultrasound Imaging
Medicine and Health Sciences
Medicine
LEFT ATRIAL VOLUME
030212 general & internal medicine
Myocardial infarction
lcsh:Science
Multidisciplinary
Ejection fraction
Radiology and Imaging
Physics
Classical Mechanics
Middle Aged
FILLING PATTERN
Magnetic Resonance Imaging
Metformin
CHRONIC HEART-FAILURE
EUROPEAN-SOCIETY
Echocardiography
Physical Sciences
Cardiology
Female
Stents
Research Article
medicine.drug
medicine.medical_specialty
Endocrine Disorders
Imaging Techniques
Surgical and Invasive Medical Procedures
Research and Analysis Methods
Placebo
EJECTION FRACTION
03 medical and health sciences
Percutaneous Coronary Intervention
CARDIAC-FUNCTION
Diagnostic Medicine
LEFT-VENTRICULAR FUNCTION
Diabetes mellitus
Internal medicine
Diabetes Mellitus
Humans
Aged
business.industry
Angioplasty
lcsh:R
Percutaneous coronary intervention
PERCUTANEOUS INTERVENTION
medicine.disease
TISSUE DOPPLER
DIABETIC-PATIENTS
Metabolic Disorders
ST Elevation Myocardial Infarction
lcsh:Q
business
Coronary Angioplasty
Subjects
Details
- Language :
- English
- ISSN :
- 19326203
- Database :
- OpenAIRE
- Journal :
- PLoS ONE, 11(12):e0168340. PUBLIC LIBRARY SCIENCE, PLoS ONE, Vol 11, Iss 12, p e0168340 (2016), PLoS ONE
- Accession number :
- edsair.doi.dedup.....8a767b811335a5db76e4a4dc788ed95a