Safety of metformin continuation in diabetic patients undergoing invasive coronary angiography: the NO-STOP single arm trial
Authors' conclusion
In 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.
Study context
- Population
- Diabetic patients on metformin undergoing coronary angiography with or without percutaneous coronary intervention, 3 European centers
- Participants
- 142 patients
- Exposure
- Metformin continuation during invasive coronary angiography
- Metformin continuationn = 142
- Outcome
- Increase in lactate levels from preprocedural levels
- Follow-up
- 72 h after the procedure
Methodological detailsopen-label, prospective, multicentre
- Open-label
- Prospective
- Multicentre
Main finding
As reported in the abstract
Lactate level (change from preprocedural)
Lactate at 72 h after coronary angiography, mmol/l (IQR 1.3-2.3)
1.7
Observational data: associations, not effects.
Secondary outcomes
Preprocedural lactate level · median preprocedural
- Median preprocedural lactate, mmol/l (IQR 1.3-2.3)
- 1.8
Hemodialysis and mortality · median follow-up 90 days (43-150)
- Patients requiring hemodialysis
- 0
- Deaths due to non-cardiac causes
- 2
Safety
Metformin-Associated Lactic Acidosis (M-ALA) and high lactate · 72 h
- Patients with 72-h lactate ≥ 5 mmol/l (5.3 mmol/l)
- 1
- Cases of M-ALA
- 0
Contrast associated-acute kidney injury (CA-AKI) and renal function
- CA-AKI, patients (6.1%)
- 9
- Median serum creatinine and eGFR remained similar throughout the periprocedural period
Original publication
Safety of metformin continuation in diabetic patients undergoing invasive coronary angiography: the NO-STOP single arm trial. Cardiovasc Diabetol. Published 6 February 2023. doi:10.
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