Evidence mapPaperPMID 21959259Full record

ReviewEuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology2012

Discontinuation of metformin in the setting of coronary angiography: clinical uncertainty amongst physicians reflecting a poor evidence base.

Annette Maznyczka, Aung Myat, Anthony Gershlick

2 registry-linked trialsAbstract readReview
PubMed Publisher
In one paragraph

Review in EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
0.7field-weighted citation impact, top 26% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT03980990 phase4unknown statusstarted 2019, after this paper: background citation

Metformin Continuation Versus Interruption Following Coronary Angiography: a Pilot Randomized Controlled Trial

Ran2019Enrolled500Registered outcomes3Posted comparisons0ConditionsAcute Coronary Syndrome, Diabetes Mellitus, Metformin Adverse Reaction, Unstable AnginaArmsMetformin
Open the trial in the graph
NCT04766008 phase4unknown statusstarted 2020, after this paper: background citation

Metformin Continuation Safety in Diabetic Patients Undergoing Coronary Angiography

Ran2020Enrolled150Registered outcomes4Posted comparisons0ConditionsContrast-induced Nephropathy, Coronary Artery Disease, Diabetes Mellitus, Lactic Acidosis With Diabetes MellitusArmsMetformin
Open the trial in the graph
3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 15 citations in OpenAlex.

  1. Trial
  2. Trial
  3. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

3 authors at 1 institution in 1 country.

Annette MaznyczkaDepartment of Cardiology, Glenfield Hospital, Leicester, United Kingdom. annette.maz@hotmail.co.uk
Aung Myat
Anthony Gershlick
Glenfield Hospital · GB

Funding

British Heart Foundation FS/11/70/28917
6 · The paper itself

Abstract

aimsMetformin 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

resultsThis review focuses on the evidence behind these guidelines and, in particular, that concerning metformin discontinuation in diabetic patients undergoing coronary angiography and percutaneous intervention. This review addresses and compares guideline-directed management of such patients and includes the results of a UK physician survey to highlight variations in clinical practice.

conclusionsWe conclude that evidence for M-ALA in diabetics on metformin undergoing coronary intervention is lacking and existing guidance on the management of such patients is inconsistent. More robust evidence is needed in the form of a large, adequately-sized randomised trial or extensive registry so that we can optimally manage those patients requiring contrast-based coronary interventions who are also taking metformin.

Indexed as

Evidence-Based MedicinePractice Patterns, Physicians'Acidosis, LacticAngioplasty, Balloon, CoronaryContraindicationsCoronary AngiographyData CollectionDiabetes MellitusGuideline AdherenceHumansHypoglycemic AgentsMetforminRisk FactorsUnited KingdomWithholding TreatmentHypoglycemic AgentsMetformin

Identifiers

PMID21959259
OpenAlexW2059324728

What Socratic holds

Texttitle and abstract
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.