Key result
A single 1000 mg dose of metformin administered prior to reteplase therapy did not significantly reduce cardiac troponin I levels or improve ST resolution compared to control in patients with STEMI.
Why the study?
Metformin exerts cardioprotective effects, but its impact as a pretreatment on cardiac troponin I levels following reteplase in STEMI was unclear.
Does a single 1000 mg oral dose of metformin prior to reteplase reduce cardiac troponin I levels in patients with STEMI undergoing thrombolytic therapy?
RCT (n=80)
Computer-generated random sequence
No
Does a single 1000 mg oral dose of metformin prior to reteplase reduce cardiac troponin I levels in patients with STEMI undergoing thrombolytic therapy?
A single 1000 mg oral dose of metformin prior to thrombolytic therapy with reteplase does not reduce myocardial injury as measured by cardiac troponin I levels or improve ST resolution in patients with STEMI.
Metformin pretreatment offers no benefit before reteplase in STEMI; confirms neutral effect on injury markers and does not support adjunctive use.
Background: Thrombolytic therapy is a key in the management of ST elevated myocardial infarction (STEMI). Metformin implies a series of cardioprotective effects. We aimed to investigate how pretreatment with metformin could affect cardiac troponin I (cTnI) levels following reteplase therapy amid STEMI patients. Methods: A pilot randomized clinical trial was carried out in 84 patients with STEMI undergoing thrombolytic therapy with reteplase. The metformin group (n = 42) received a single dose of 1000 mg metformin orally before receiving reteplase, while the control group (n = 42) received only reteplase. The serum level of cTnI was measured at baseline, 8, 16, 24, and 32 hours after the admission to assess myocardial damage. Results: No significant differences were observed in cTnI levels at baseline (p = 0.657), 8 (p = 0.93), 16 (p = 0.690), 24 (p = 0.217), and 32 (p = 0.517) hours after STEMI diagnose between two groups. The mean differences were also not significant for changes of cTnI at baseline and other time frames. Conclusion: The results of the present study indicated that early use of 1000 mg metformin prior to reteplase could not reduce the level of cTnI in STEMI patients.
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Aslanabadi et al. (2022) conducted an RCT in ST elevation myocardial infarction (STEMI) (n=80). Metformin vs. Reteplase alone (control) was evaluated on Serum level of cardiac troponin I (cTnI) at 8 hours (p=0.93). A single 1000 mg dose of metformin administered prior to reteplase therapy did not significantly reduce cardiac troponin I levels or improve ST resolution compared to control in patients with STEMI.
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