Observational studyCardiovascular diabetology2026
Prognostic impact of metformin in diabetic patients undergoing a percutaneous coronary intervention (PCI): protective effect is modified by procedural complexity.
Observational study in Cardiovascular diabetology, 2026. The graph read 3 numbers from its abstract, feeding 2 cells of the map, but none could be read as for or against, so it casts no vote. It also reports an association that does not count as treatment evidence, such as HR 0.80 (0.70 to 0.92) for cardiovascular events. Cited by 1 paper.
What it found
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Significantly lower incidence of MACCEs was observed in patients undergoing non-complex PCI (adjusted HR 0.65, 95% CI: 0.53-0.79), while such protective effect of metformin didn’t exist in complex PCI patients (adjusted HR 1.00, 95%CI: 0.83-1.21).
Overall, metformin use was observed to be associated with a lower incidence of 3-year MACCEs (adjusted HR 0.80, 95%CI 0.70-0.92) after multivariable adjustment.
Significantly lower incidence of MACCEs was observed in patients undergoing non-complex PCI (adjusted HR 0.65, 95% CI: 0.53-0.79), while such protective effect of metformin didn’t exist in complex PCI patients (adjusted HR 1.00, 95%CI: 0.83-1.21).
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Where it lands on the map
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What it adds to each cell
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Cardiac procedures & devices×cardiovascular events
No readable resultOpen on the map →What to test next →3 readable studies in this cell: 2 favour the treatment, 0 find no difference, 1 favour the comparator.
This paper's own estimate is on a different scale from the rest of the cell, so it is not drawn here.
Metformin×cardiovascular events
No readable resultOpen on the map →What to test next →5 readable studies in this cell: 4 favour the treatment, 1 find no difference, 0 favour the comparator.
This paper's own estimate is on a different scale from the rest of the cell, so it is not drawn here.
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.
Who cites it
1 citing paper in PubMed.
- Synergistic effects of insulin resistance and revascularization completeness on prognosis in patients with coronary artery calcification.Cardiovascular diabetology · 2026Observational
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors.
Funding
Abstract
The marked sentences are the ones the graph read a number from.
backgroundMetformin, a widely prescribed glucose-lowering agent, has demonstrated cardiovascular benefits in patients with diabetes who do not have established atherosclerotic cardiovascular disease. However, evidence regarding its role specifically in patients with diabetes undergoing percutaneous coronary intervention (PCI) remains limited. This study therefore aimed to evaluate the prognostic association of metformin use in this high‑risk population and to explore its potential interaction with procedural complexity.
methodsFrom January 2017 to December 2018, 11,585 diabetic patients undergoing PCI at Fuwai hospital were consecutively enrolled in our study. Patients were categorized into four groups according to metformin use and PCI complexity. The primary endpoint was major adverse cardiovascular and cerebrovascular events (MACCEs), including cardiovascular death, non-fatal myocardial infarction (MI), non-fatal stroke, and unplanned revascularization.
resultsAfter a follow-up of 3 years, a total of 1292 MACCEs were recorded. Overall, metformin use was observed to be associated with a lower incidence of 3-year MACCEs (adjusted HR 0.80, 95%CI 0.70–0.92) after multivariable adjustment. Significantly lower incidence of MACCEs was observed in patients undergoing non-complex PCI (adjusted HR 0.65, 95% CI: 0.53–0.79), while such protective effect of metformin didn’t exist in complex PCI patients (adjusted HR 1.00, 95%CI: 0.83–1.21). Significant interaction between metformin and PCI complexity was found with regard to the 3-year MACCE rate (Pinteraction = 0.003; adjusted Pinteraction = 0.002).
conclusionsIn this observational study, there was significant difference in the efficacy of metformin in diabetic patients undergoing complex or non-complex PCI. Metformin use was associated with improved prognosis in patients with diabetes undergoing non-complex PCI.
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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.