Evidence mapPaperPMID 36747244Full record

Trial reportCardiovascular diabetology2023

Safety of metformin continuation in diabetic patients undergoing invasive coronary angiography: the NO-STOP single arm trial.

Mauro Chiarito, Jorge Sanz-Sanchez, Raffaele Piccolo, Francesco Condello, Gaetano Liccardo, Matteo Maurina, Marisa Avvedimento, Damiano Regazzoli, Paolo Pagnotta, Hector M Garcia-Garcia and 7 more

Registry-linked trialOpen access · goldFull text readClinical TrialMulticenter Study
In one paragraph

Trial report in Cardiovascular diabetology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It reports registered trial NCT04766008. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
1.4field-weighted citation impact, top 20% 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.

NCT04766008 phase4unknown status

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

2 citing papers in PubMed, 6 citations in OpenAlex.

  1. Article
  2. 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

17 authors at 7 institutions in 3 countries.

Mauro Chiarito *Cardio Center, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy.
Jorge Sanz-Sanchez *Hospital Universitario y Politécnico La Fe, Valencia, Spain.
Raffaele PiccoloDepartment of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy.
Francesco CondelloCardio Center, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy.
Gaetano LiccardoCardio Center, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy.
Matteo MaurinaCardio Center, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy.
Marisa AvvedimentoDepartment of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy.
Damiano RegazzoliCardio Center, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy.
Paolo PagnottaCardio Center, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy.
Hector M Garcia-GarciaSection of Interventional Cardiology, MedStar Washington Hospital Center, Washington, DC, USA.
Roxana MehranIcahn School of Medicine at Mount Sinai, New York City, NY, USA.
Massimo FedericiDepartment of Systems Medicine, University of Rome Tor Vergata, Rome, Italy.
Gianluigi CondorelliCardio Center, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy.
Jose Luis Diez GilHospital Universitario y Politécnico La Fe, Valencia, Spain.
Bernhard ReimersCardio Center, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy.
Giuseppe FerranteCardio Center, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy.
Giulio StefaniniCardio Center, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy. giulio.stefanini@hunimed.eu.
Humanitas University · ITIRCCS Humanitas Research Hospital · ITHospital Universitari i Politècnic La Fe · ESUniversity of Naples Federico II · ITIcahn School of Medicine at Mount Sinai · USMedStar Washington Hospital Center · USUniversity of Rome Tor Vergata · IT

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundDespite paucity of data, it is common practice to discontinue metformin before invasive coronary angiography due to an alleged risk of Metformin-Associated Lactic Acidosis (M-ALA). We aimed at assessing the safety of metformin continuation in diabetic patients undergoing coronary angiography in terms of significant increase in lactate levels.

methodsIn this open-label, prospective, multicentre, single-arm trial, all diabetic patients undergoing coronary angiography with or without percutaneous coronary intervention at 3 European centers were screened for enrolment. The primary endpoint was the increase in lactate levels from preprocedural levels at 72-h after the procedure. Secondary endpoints included contrast associated-acute kidney injury (CA-AKI), M-ALA, and all-cause mortality.

results142 diabetic patients on metformin therapy were included. Median preprocedural lactate level was 1.8 mmol/l [interquartile range (IQR) 1.3-2.3]. Lactate levels at 72 h after coronary angiography were 1.7 mmol/l (IQR 1.3-2.3), with no significant differences as compared to preprocedural levels (p = 0.91; median difference = 0; IQR - 0.5 to 0.4 mmol/l). One patient had 72-h levels ≥ 5 mmol/l (5.3 mmol/l), but no cases of M-ALA were reported. CA-AKI occurred in 9 patients (6.1%) and median serum creatinine and estimated glomerular filtration rate remained similar throughout the periprocedural period. At a median follow-up of 90 days (43-150), no patients required hemodialysis and 2 patients died due to non-cardiac causes.

conclusionsIn diabetic patients undergoing invasive coronary angiography, metformin continuation throughout the periprocedural period does not increase lactate levels and was not associated with any decline in renal function.

trial registrationThe study was registered at Clinicaltrials.gov (NCT04766008).

Indexed as

Acidosis, LacticAcute Kidney InjuryDiabetes MellitusMetforminCoronary AngiographyHumansHypoglycemic AgentsLactatesProspective StudiesHypoglycemic AgentsLactatesMetforminCoronary angiographyMetforminMetformin-associated lactic acidosisPercutaneous coronary intervention

Identifiers

PMID36747244
PMCPMC9902064
OpenAlexW4319304693

What Socratic holds

Textfull text, public
LicenceCC BY
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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.