Evidence map›Paper›PMID 27977774›Full record

Trial reportPloS one2016

The Effect of Metformin on Diastolic Function in Patients Presenting with ST-Elevation Myocardial Infarction.

Lawien Al Ali, Minke T Hartman, Chris P H Lexis, Yoran M Hummel, Erik Lipsic, Joost P van Melle, Dirk J van Veldhuisen, Adriaan A Voors, Iwan C C van der Horst, Pim van der Harst

Open access · goldAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in PloS one, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
14citing papers in PubMed, 3 pooled it
1.6field-weighted citation impact, top 14% 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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

14 citing papers in PubMed, 3 syntheses or guidelines pooled it, 24 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Trial
  5. Review
  6. Review
  7. Article
  8. Article
  9. Article
  10. Review
  11. Review
  12. Review
  13. Review
  14. Article
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

10 authors at 2 institutions in 1 country.

Lawien Al AliDepartment of Cardiology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands.
Minke T HartmanDepartment of Cardiology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands.
Chris P H LexisDepartment of Cardiology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands.
Yoran M HummelDepartment of Cardiology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands.
Erik LipsicDepartment of Cardiology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands.
Joost P van MelleDepartment of Cardiology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands.
Dirk J van VeldhuisenDepartment of Cardiology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands.
Adriaan A VoorsDepartment of Cardiology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands.
Iwan C C van der HorstDepartment of Critical Care, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands.
Pim van der HarstDepartment of Cardiology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands.
University Medical Center Groningen · NLUniversity of Groningen · NL

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

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.

Indexed as

AgedDiastoleEchocardiographyFemaleHumansMaleMetforminMiddle AgedPercutaneous Coronary InterventionPostoperative ComplicationsST Elevation Myocardial InfarctionStentsVentricular Dysfunction, LeftVentricular Function, LeftMetformin

Identifiers

PMID27977774
PMCPMC5158040
OpenAlexW2562372881

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

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.