Metformin Continuation Versus Interruption Following Coronary Angiography: a Pilot Randomized Controlled Trial
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Study Type
Study Type
Enrollment (Anticipated)
Enrollment
Phase
Phase
- Phase 4
Contacts and Locations
Study Contact
Study Contact
- Name: Jay Shavadia, MD
- Phone Number: 3066553932
- Email: jss372@usask.ca
Study Locations
-
-
Saskatchewan
-
Saskatoon, Saskatchewan, Canada, S7N0W8
- Recruiting
- Royal University Hospital
-
Contact:
- Jay Shavadia, MD
- Phone Number: 3066553932
- Email: jss372@usask.ca
-
Principal Investigator:
- Jay Shavadia, MD
-
Sub-Investigator:
- Rajan Minhas, MD
-
Sub-Investigator:
- Haissam Haddad, MD
-
Sub-Investigator:
- Colin Pearce, MD
-
Sub-Investigator:
- Gudrun Caspar-Bell, MD
-
Sub-Investigator:
- Alex Zhai, MD
-
Sub-Investigator:
- Calvin Wells, MD
-
Sub-Investigator:
- Jason Orvold, MD
-
Sub-Investigator:
- Udoka Okpalauwaekwe, MBBS
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Age ≥ 18 years
- On metformin therapy
- Angiography for ACS or elective non-ACS related indications
- Informed consent received
Exclusion Criteria:
- Cardiogenic shock prior to randomization
- Cardiac arrest prior to randomization
- Established severe CKD (eGFR<30, or on dialysis)
- Chronic liver disease
- Need for CABG within 48 hours of hospitalization
- Inability to follow the protocol and comply with follow-up requirements or any other reason that the investigator feels would place the patient at increased risk if the investigational therapy is initiated
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Experimental: Metformin Continuation
Patients undergoing angiography will continue their metformin without interruption at their next scheduled dose following angiography.
|
Continuation of Metformin
|
|
No Intervention: Metformin Interruption
Patients undergoing angiography will interrupt their metformin for 48 hours post angiography.
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Lactic Acidosis
Time Frame: 48-72 hours (or 72 hours for patients with staged PCI procedures within 48 hours of randomization)
|
Lactate Level >5 mmol/L and HCO3<18
|
48-72 hours (or 72 hours for patients with staged PCI procedures within 48 hours of randomization)
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Acute Kidney Injury
Time Frame: 48-72 hours (or 72 hours for patients with staged PCI procedures within 48 hours of randomization)
|
Rise in baseline creatinine >/= 25% or 27 umol/L
|
48-72 hours (or 72 hours for patients with staged PCI procedures within 48 hours of randomization)
|
|
All cause mortality at hospital discharge
Time Frame: Duration of hospital admission
|
Death in hospital
|
Duration of hospital admission
|
Collaborators and Investigators
Sponsor
Sponsor
Investigators
Investigators
- Principal Investigator: Jay Shavadia, MD, University of Saskatchewan, Department of Medicine, Division of Cardiology
Publications and helpful links
General Publications
- Maznyczka A, Myat A, Gershlick A. Discontinuation of metformin in the setting of coronary angiography: clinical uncertainty amongst physicians reflecting a poor evidence base. EuroIntervention. 2012 Jan;7(9):1103-10. doi: 10.4244/EIJV7I9A175.
- Salpeter SR, Greyber E, Pasternak GA, Salpeter EE. Risk of fatal and nonfatal lactic acidosis with metformin use in type 2 diabetes mellitus. Cochrane Database Syst Rev. 2010 Apr 14;2010(4):CD002967. doi: 10.1002/14651858.CD002967.pub4.
- Misbin RI, Green L, Stadel BV, Gueriguian JL, Gubbi A, Fleming GA. Lactic acidosis in patients with diabetes treated with metformin. N Engl J Med. 1998 Jan 22;338(4):265-6. doi: 10.1056/NEJM199801223380415. No abstract available.
- Oktay V, Calpar Cirali I, Sinan UY, Yildiz A, Ersanli MK. Impact of continuation of metformin prior to elective coronary angiography on acute contrast nephropathy in patients with normal or mildly impaired renal functions. Anatol J Cardiol. 2017 Nov;18(5):334-339. doi: 10.14744/AnatolJCardiol.2017.7836. Epub 2017 Oct 31.
- Zeller M, Labalette-Bart M, Juliard JM, Potier L, Feldman LJ, Steg PG, Cottin Y, Roussel R. Metformin and contrast-induced acute kidney injury in diabetic patients treated with primary percutaneous coronary intervention for ST segment elevation myocardial infarction: Amulticenter study. Int J Cardiol. 2016 Oct 1;220:137-42. doi: 10.1016/j.ijcard.2016.06.076. Epub 2016 Jun 23.
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Anticipated)
Primary Completion
Study Completion (Anticipated)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- OA-UofS-778
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
product manufactured in and exported from the U.S.
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.