title: Protective effect of metformin on myocardial injury in metabolic syndrome patients following percutaneous coronary intervention.
abstract: OBJECTIVE
  The present study tested the hypothesis that pretreatment with metformin decreases postprocedural myocardial injury and improves clinical outcomes in metabolic syndrome patients following percutaneous coronary intervention (PCI).
  
  
  METHODS
  We enrolled 152 metabolic syndrome patients with no prior history of metformin treatment. Patients scheduled for elective coronary intervention were randomized to the metformin or control group 7 days before the procedure. Creatine kinase-MB (CK-MB) and troponin I levels were measured at baseline and 8 and 24 h after the procedure, and clinical outcomes were monitored for 1 year.
  
  
  RESULTS
  Post-PCI myocardial injury as indicated by CK-MB elevation (14.5 vs. 32.9%, p = 0.008) and troponin I elevation (14.5 vs. 34.2%, p = 0.005) was significantly lower in the metformin group than in the control group. Postprocedural peak values of CK-MB (2.70 ± 4.30 vs. 6.29 ± 8.03 ng/ml, p < 0.001) and troponin I (0.02 ± 0.05 vs. 0.07 ± 0.10 ng/ml, p = 0.001) were also significantly lower in the metformin group than in the control group. At 1 year, the composite endpoint of death from any cause, post-PCI myocardial infarction (MI), MI after PCI hospitalization or ischemia-driven target lesion revascularization occurred in 7.9% of metformin-treated patients and 28.9% of controls (hazard ratio 0.25, 95% CI 0.10-0.62, log rank p = 0.001).
  
  
  CONCLUSIONS
  A 7-day metformin pretreatment regimen (250 mg 3 times a day) significantly reduces postprocedural myocardial injury and improves 1-year clinical outcomes in metabolic syndrome patients undergoing PCI.
authors: Department of Cardiology, Affiliated Hospital of Hebei University, Baoding, China.
authors: Jing
authors: J
authors: Li
authors: Jin-Peng
authors: JP
authors: Xu
authors: Xing-Zhou
authors: XZ
authors: Zhao
authors: Xue-Jiang
authors: XJ
authors: Sun
authors: Zhan-Wen
authors: ZW
authors: Xu
authors: Shu-Jiang
authors: SJ
authors: Song
mesh_terms: D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000378:metabolism; D002316:Cardiotonic Agents / Q000627:therapeutic use*; D052279:Creatine Kinase, MB Form / Q000378:metabolism; D006801:Humans; D024821:Metabolic Syndrome / Q000150:complications*; D008687:Metformin / Q000627:therapeutic use*; D008875:Middle Aged; D009203:Myocardial Infarction / Q000628:therapy; D015428:Myocardial Reperfusion Injury / Q000517:prevention & control*; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects; D011446:Prospective Studies; D019210:Troponin I / Q000378:metabolism; D055815:Young Adult
chemical_list: D015415:Biomarkers; D002316:Cardiotonic Agents; D019210:Troponin I; D008687:Metformin; D052279:Creatine Kinase, MB Form