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metformin and coronary angiography

Héctor Cubero-Gallego, Rafael Romaguera, Josep Gómez-Lara, Joan A Gómez-Hospital, Manel Sabaté, Eduardo Pinar, Montserrat Gracida, Gerard Roura, José L Ferreiro, Luis Teruel, Cristian Tebé-Codorni, Pilar Jiménez-Quevedo, Eduard Montanya, Fernando Alfonso, Ángel Cequier
INTRODUCTION AND OBJECTIVES: Recent animal studies have shown metformin (MF) to impair endothelialization of drug-eluting stents (DES). The aim of this study was to evaluate the effect of MF on the healing of DES in human coronary arteries of patients with diabetes mellitus by optical coherence tomography (OCT). METHODS: The RESERVOIR trial randomized 116 lesions in 112 patients with diabetes mellitus to amphilimus- or everolimus-eluting stents and included mandatory OCT at 9 months of follow-up...
January 25, 2018: Revista Española de Cardiología
Veysel Oktay, İlknur Calpar Çıralı, Ümit Yaşar Sinan, Ahmet Yıldız, Murat Kazım Ersanlı
OBJECTIVE: Discontinuation of metformin treatment in patients scheduled for elective coronary angiography (CAG) is controversial because of post-procedural risks including acute contrast-induced nephropathy (CIN) and lactic acidosis (LA). This study aims to discuss the safety of continuing metformin treatment in patients undergoing elective CAG with normal or mildly impaired renal functions. METHODS: Our study was designed as a single-centered, randomized, and observational study including 268 patients undergoing elective CAG with an estimated glomerular filtration rate of >60 mL/min/1...
October 31, 2017: Anatolian Journal of Cardiology
Penny Whiting, Andrew Morden, Laurie A Tomlinson, Fergus Caskey, Thomas Blakeman, Charles Tomson, Tracey Stone, Alison Richards, Jelena Savović, Jeremy Horwood
OBJECTIVES: To summarise evidence on temporary discontinuation of medications to prevent acute kidney injury (AKI). DESIGN: Systematic review and meta-analysis of randomised and non-randomised studies. PARTICIPANTS: Adults taking diuretics, ACE inhibitors (ACEI), angiotensin receptor blockers (ARB), direct renin inhibitors, non-steroidal anti-inflammatories, metformin or sulfonylureas, experiencing intercurrent illnesses, radiological or surgical procedures...
April 7, 2017: BMJ Open
Mohammad Reza Raee, Arash Aghajani Nargesi, Behnam Heidari, Mohammad Ali Mansournia, Mehrdad Larry, Soghra Rabizadeh, Mitra Zarifkar, Alireza Esteghamati, Manouchehr Nakhjavani
BACKGROUND: Both metformin and sulfonylurea (SU) drugs are among the most widely-used anti-hyperglycemic medications in patients with type 2 diabetes mellitus (T2DM). Previous studies have shown that treatment with SUs might be associated with decreased survival compared with metformin. This study aimed to evaluate all-cause and cardiovascular mortality rates between glyburide and metformin in patients diagnosed with T2DM. METHODS: This was a cohort study on 717 patients with T2DM (271 undergoing monotherapy with glyburide and 446 with metformin)...
March 2017: Archives of Iranian Medicine
Claudia Stöllberger, Maria Heger, Josef Finsterer
Spontaneous hemopericardium is a complication of anticoagulant therapy with not only vitamin-K-antagonists, but also with nonvitamin-K-antagonist oral anticoagulants. We report a polymorbid 75-year old male under a therapy with dabigatran, valsartan, amlodipine, nicorandil, furosemide, atorvastatin, bisoprolol, metformin, tizanidine, pantoprazole, and tramadol. He suffered from chest pain for 4 months. Coronary angiography showed only ectatic coronary arteries. He started taking nonsteroidal anti-inflammatory drugs...
March 2017: Blood Coagulation & Fibrinolysis: An International Journal in Haemostasis and Thrombosis
Neil F Goodman, Rhoda H Cobin, Walter Futterweit, Jennifer S Glueck, Richard S Legro, Enrico Carmina
Polycystic ovary syndrome (PCOS) is recognized as the most common endocrine disorder of reproductive-aged women around the world. This document, produced by the collaboration of the American Association of Clinical Endocrinologists and the Androgen Excess Society aims to highlight the most important clinical issues confronting physicians and their patients with PCOS. It is a summary of current best practices in 2014. Insulin resistance is believed to play an intrinsic role in the pathogenesis of PCOS. The mechanism by which insulin resistance or insulin give rise to oligomenorrhea and hyperandrogenemia, however, is unclear...
December 2015: Endocrine Practice
Olga Kruszelnicka, Bernadeta Chyrchel, Alain Golay, Andrzej Surdacki
Metformin, the drug of first choice in type 2 diabetes mellitus (T2DM), reduces cardiovascular (CV) morbidity and mortality in part independently of improved glycemic control and changes in traditional risk factors. However, there are discordant reports on the effects of metformin on endothelial function in T2DM. Our aim was to compare biochemical endothelial markers in patients with stable coronary artery disease (CAD) and T2DM stratified by metformin use. We studied 70 patients (29 women, age 68 ± 9 years) with established T2DM referred for elective coronary angiography owing to stable angina who were receiving a standard CV medication and metformin or other oral antidiabetic drugs...
September 2015: Amino Acids
Surya Ramachandran, Anila Venugopal, V Raman Kutty, Vinitha A, Divya G, V Chitrasree, Ajit Mullassari, N S Pratapchandran, K R Santosh, M Radhakrishna Pillai, C C Kartha
AIMS/HYPOTHESIS: Cyclophilin A, an immunophilin is secreted from human monocytes activated by high glucose. Given its role as an inflammatory mediator of vascular tissue damage associated with inflammation and oxidative stress, we examined plasma levels of cyclophilin A in normal healthy volunteers and patients with type 2 diabetes (DM), with or without coronary artery disease (CAD). METHODS: Study subjects comprised of 212 patients with DM and CAD,101 patients with diabetes, 122 patients with CAD and 121 normal healthy volunteers...
2014: Cardiovascular Diabetology
Stephan Schiekofer, Izabela Bobak, Marcus E Kleber, Winfried Maerz, Gottfried Rudofsky, Klaus A Dugi, Jochen G Schneider
OBJECTIVE: Type 2 diabetes is accompanied by increased mortality from coronary artery disease (CAD), but the mechanisms linking these conditions remain elusive. Hence, treatment of hyperglycaemia alone is not sufficient to avoid CAD in diabetes. Alternative views suggest that metabolic and vascular diseases share unifying cellular defects that could serve as targets for novel therapeutic strategies. Recently, a variant [single-nucleotide polymorphism (SNP); rs11212617] near the gene for ataxia telangiectasia mutated (ATM) has been associated with glycaemic response to metformin...
January 2014: Diabetes & Vascular Disease Research
Yu Kataoka, Mingyuan Shao, Kathy Wolski, Kiyoko Uno, Rishi Puri, E Murat Tuzcu, Steven E Nissen, Stephen J Nicholls
BACKGROUND: Diabetic patients with coronary artery disease (CAD) demonstrate accelerated progression of coronary atherosclerosis. The impact of multiple risk factor intervention on disease progression has not been investigated. DESIGN: We investigated 448 diabetic patients with angiographic CAD who underwent serial intravascular ultrasound imaging to monitor the change in atheroma burden in seven clinical trials. METHODS: Disease progression was compared in patients stratified according to whether they achieved increasing numbers of treatment goals of individual risk factors (HbA1c <7...
April 2013: European Journal of Preventive Cardiology
Annette Maznyczka, Aung Myat, Anthony Gershlick
AIMS: Metformin is widely prescribed for the treatment of type 2 diabetes mellitus and is associated with a reduction in diabetes-induced cardiovascular morbidity and mortality. Concerns about metformin-associated lactic acidosis (M-ALA) in patients undergoing contrast-based angiographic procedures have led to the development and publication of a number of guidelines to improve the management of this patient cohort. METHODS AND RESULTS: This review focuses on the evidence behind these guidelines and, in particular, that concerning metformin discontinuation in diabetic patients undergoing coronary angiography and percutaneous intervention...
January 2012: EuroIntervention
Fulvio Stacul, Aart J van der Molen, Peter Reimer, Judith A W Webb, Henrik S Thomsen, Sameh K Morcos, Torsten Almén, Peter Aspelin, Marie-France Bellin, Olivier Clement, Gertraud Heinz-Peer
PURPOSE: The Contrast Media Safety Committee (CMSC) of the European Society of Urogenital Radiology (ESUR) has updated its 1999 guidelines on contrast medium-induced nephropathy (CIN). AREAS COVERED: Topics reviewed include the definition of CIN, the choice of contrast medium, the prophylactic measures used to reduce the incidence of CIN, and the management of patients receiving metformin. Key Points • Definition, risk factors and prevention of contrast medium induced nephropathy are reviewed...
December 2011: European Radiology
Charlotte Andersson, Peter Søgaard, Søren Hoffmann, Peter R Hansen, Allan Vaag, Atheline Major-Pedersen, Thomas Fritz Hansen, Jan Bech, Lars Køber, Christian Torp-Pedersen, Gunnar H Gislason
OBJECTIVE: To examine the association between selected glucose-lowering medications and left ventricular (LV) diastolic function in patients with diabetes. DESIGN: Retrospective cohort study (years 2005-2008). METHODS: Echocardiograms of 242 patients with diabetes undergoing coronary angiography were analyzed. All patients had an LV ejection fraction (LVEF) ≥20% and were without atrial fibrillation, bundle branch block, valvular disease, or cardiac pacemaker...
October 2010: European Journal of Endocrinology
Sulieman Hamid, Fiona Bainbridge, Anne-Maree Kelly, Debra Kerr
OBJECTIVES: Serial electrocardiographic and biomarker data are used to rule out acute coronary syndrome (ACS) in emergency department (ED) patients with chest pain. These do not identify coronary artery disease (CAD). Functional tests are often used but have limitations. Multislice computed tomography coronary angiography (MSCT-CA) is evolving rapidly, raising the possibility of fast, accurate, and relatively noninvasive anatomical testing for CAD. We aimed to quantify the proportion of ED rule-out ACS patients suitable for MSCT-CA...
May 2010: American Journal of Emergency Medicine
P Calabrò, R Bianchi, M Caprile, C Sordelli, M Cappelli Bigazzi, R Palmieri, G Gigantino, G Limongelli, G Capozzi, S Cuomo, R Calabrò
AIM: Contrast-induced nephropathy (CIN) is most commonly defined as acute renal failure occurring within 48-72 h of exposure to intravascular radiographic contrast medium that is not attributable to other causes. In international literature a 25% increase in serum creatinine levels or an increase in absolute values of 0.5 mg/dL from baseline has been suggested to define CIN. The reported incidence of CIN varies widely, ranging from 2% to 50%. This variability results from differences in the presence or absence of risk factors...
February 2010: Minerva Cardioangiologica
Zdravko M Mijailović, Zoran Stajić, Miodrag Jevtić, Srdan Aleksandrić, Radomir Matunović, Dragan Tavciovski
While the performance of percutaneous coronary interventions remains the domain of interventional cardiologists, the management of these patients before, during, and after the procedure is in the domain of general cardiologists, internists and primary care physicians. Therefore, for optimal patient care it is crucial that all engaged physicians should understand the procedural risks, complications and optimal treatment strategy before, during and after the procedure. Before a percutanous coronary intervention, patients with known allergies to iodinated contrast dye should be pretreated with oral corticosteroids and H1-receptor blockers...
July 2009: Medicinski Pregled
Robert L Frye, Phyllis August, Maria Mori Brooks, Regina M Hardison, Sheryl F Kelsey, Joan M MacGregor, Trevor J Orchard, Bernard R Chaitman, Saul M Genuth, Suzanne H Goldberg, Mark A Hlatky, Teresa L Z Jones, Mark E Molitch, Richard W Nesto, Edward Y Sako, Burton E Sobel
BACKGROUND: Optimal treatment for patients with both type 2 diabetes mellitus and stable ischemic heart disease has not been established. METHODS: We randomly assigned 2368 patients with both type 2 diabetes and heart disease to undergo either prompt revascularization with intensive medical therapy or intensive medical therapy alone and to undergo either insulin-sensitization or insulin-provision therapy. Primary end points were the rate of death and a composite of death, myocardial infarction, or stroke (major cardiovascular events)...
June 11, 2009: New England Journal of Medicine
Ching-Chang Fang, Yeun Tarl Fresner Ng Jao, Yi-Chen, Ching-Lung Yu, Chi-Liang Chen, Shih-Pu Wang
A beneficial effect of thiazolidinediones includes the reduction of intermediate markers, suggesting a potential for reducing atherosclerosis and restenosis. The objective of this study was to determine if rosiglitazone (RSG) reduced the odds of restenosis and if RSG improved the odds of clinical outcomes after percutaneous coronary intervention (PCI) in type 2 diabetes mellitus (DM) patients. A total of 609 patients with 734 lesions were selected from the period between January 1, 2001 and January 31, 2004...
October 2007: Angiology
Marc J Schweiger, Charles E Chambers, Charles J Davidson, Shaoheng Zhang, James Blankenship, Narinder P Bhalla, Peter C Block, John P Dervan, Christine Gasperetti, Lowell Gerber, Neal S Kleiman, Ronald J Krone, William J Phillips, Robert M Siegel, Barry F Uretsky, Warren K Laskey
Contrast induced nephropathy (CIN) is the third leading cause of hospital acquired renal failure and is associated with significant morbidity and mortality. Chronic kidney disease is the primary predisposing factor for CIN. As estimated glomerular filtration rate<60 ml/1.73 m2 represents significant renal dysfunction and defines patients at high risk. Modifiable risk factors for CIN include hydration status, the type and amount of contrast, use of concomitant nephrotoxic agents and recent contrast administration...
January 2007: Catheterization and Cardiovascular Interventions
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