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type=\u0022text\/css\u0022 rel=\u0022stylesheet\u0022 href=\u0022\/\/d282kpwvnogo5m.cloudfront.net\/sites\/default\/files\/advagg_css\/css__ce2QY63WIanKyr8eSq7eavr1XQRRmFD6ZSmwpyJi8lM__zXwFqpqmxrZOXXcd_TpBQpjuELbmIP9wBR5UuTDWAO4__YJWWMMdfCJuAFm5cUEp88OsodhO3ZA-2lzRfoBsSlk4.css\u0022 media=\u0022all\u0022 \/\u003E\n\u003Clink rel=\u0027stylesheet\u0027 type=\u0027text\/css\u0027 href=\u0027\/sites\/all\/modules\/contrib\/panels\/plugins\/layouts\/onecol\/onecol.css\u0027 \/\u003E\u003C\/head\u003E\u003Cbody\u003E\u003Cdiv class=\u0022panels-ajax-tab-panel panels-ajax-tab-panel-sageoa-tab-art\u0022\u003E\u003Cdiv class=\u0022panel-display panel-1col clearfix\u0022 \u003E\n  \u003Cdiv class=\u0022panel-panel panel-col\u0022\u003E\n    \u003Cdiv\u003E\u003Cdiv class=\u0022panel-pane pane-highwire-markup\u0022 \u003E\n  \n      \n  \n  \u003Cdiv class=\u0022pane-content\u0022\u003E\n    \u003Cdiv class=\u0022highwire-markup\u0022\u003E\u003Cdiv xmlns=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022 id=\u0022content-block-markup\u0022 xmlns:xhtml=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022\u003E\u003Cdiv class=\u0022article fulltext-view \u0022\u003E\u003Cspan class=\u0022highwire-journal-article-marker-start\u0022\u003E\u003C\/span\u003E\u003Cdiv class=\u0022section abstract\u0022 id=\u0022abstract-1\u0022\u003E\u003Ch2\u003ESummary\u003C\/h2\u003E\n            \u003Cp id=\u0022p-1\u0022\u003EMetformin has no effect on diastolic function following acute myocardial infarction (MI) in nondiabetic patients. The disappointing finding from the Glycometabolic Interventions in Patients Presenting With ST-Segment Elevation Myocardial Infarction trial [GIPS-III; Lexis CP et al. \u003Cem\u003EJAMA\u003C\/em\u003E 2014] is discussed in this article.\u003C\/p\u003E\n         \u003C\/div\u003E\u003Cul class=\u0022kwd-group\u0022\u003E\u003Cli class=\u0022kwd\u0022\u003EMyocardial Infarction\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003ECardiology Clinical Trials\u003C\/li\u003E\u003C\/ul\u003E\u003Cul class=\u0022kwd-group clinical-trial\u0022\u003E\u003Cli class=\u0022kwd\u0022\u003ECardiology \u0026amp; Cardiovascular Medicine\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003EMyocardial Infarction\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003ECardiology Clinical Trials\u003C\/li\u003E\u003C\/ul\u003E\u003Cp id=\u0022p-2\u0022\u003EMetformin has no effect on diastolic function following acute myocardial infarction (MI) in nondiabetic patients. The disappointing finding from the Glycometabolic Interventions in Patients Presenting With ST-Segment Elevation Myocardial Infarction trial [GIPS-III; Lexis CP et al. \u003Cem\u003EJAMA\u003C\/em\u003E 2014] was reported by Chris P. H. Lexis, MD, University Medical Center Groningen, Groningen, the Netherlands.\u003C\/p\u003E\u003Cp id=\u0022p-3\u0022\u003ELeft ventricular dysfunction following MI occurs in 30% to 50% of patients, of which 15% to 30% will develop heart failure. Left ventricular dysfunction is the strongest predictor of poor outcomes following an ST-segment elevation MI (STEMI). Post-STEMI patients experiencing heart failure at admission or during initial hospitalization are at markedly higher risk when compared to patients with no heart failure [Steg PG et al. \u003Cem\u003ECirculation\u003C\/em\u003E 2004]. The researchers became interested in the possible benefit of metformin\u2014the number one\u2013prescribed antihyperglycemic drug\u2014given animal studies that found that metformin improved left ventricular ejection fraction. In addition, some studies found an association between reduced all-cause mortality in patients with diabetes treated with metformin [UK Prospective Diabetes Study Group. \u003Cem\u003ELancet\u003C\/em\u003E 1998].\u003C\/p\u003E\u003Cp id=\u0022p-4\u0022\u003EGIPS-III was a double-blind, placebo-controlled, parallel-group trial that comprised 379 patients. The 371 patients that received at least an assessment of diastolic function were randomly assigned (1:1) to receive metformin (500 mg, twice a day [BID]; n=187) or placebo (BID; n=184). The treatments commenced immediately after percutaneous coronary intervention (PCI) and continued for 4 months. The objective of the study was to evaluate the effect of metformin on left ventricular diastolic function during hospitalization and at 4 months in nondiabetic patients with STEMI.\u003C\/p\u003E\u003Cp id=\u0022p-5\u0022\u003EPatients were eligible if they were at least 18 years old with STEMI, had received a primary PCI with \u22653.0-mm-diameter stents, and had a thrombolysis in MI flow grade \u22652 after PCI. Patients were excluded if they were diabetic, had a prior MI, required cardiothoracic surgery, were contraindicated for magnetic resonance imaging, or had severe renal impairment. Transthoracic echocardiography was done in the left decubital position during hospitalization to assess the short-term effect and again at 4 months. Assessors were blinded to treatment and clinical information. Diastolic individual assessment parameters (grade 0 to 3) included age, heart rate, size and mass, left atrial volume index, E\/A ratio, deceleration time, e\u0027, E\/e\u0027 ratio, and estimated pulmonary pressure.\u003C\/p\u003E\u003Cp id=\u0022p-6\u0022\u003EThe baseline characteristics of the 2 groups were similar, except for the higher prevalence of dyslipidemia and previous PCI in the placebo group and the longer ischemia time and greater creatinine kinase elevation in the metformin group.\u003C\/p\u003E\u003Cp id=\u0022p-7\u0022\u003EThe metformin and placebo groups were not appreciably different in the extent of normal and abnormal diastolic function during hospitalization and at 4 months. Similar grades of diastolic dysfunction and change of diastolic function were evident between groups at both times. Finally, all the assessed parameters were similar during hospitalization and at 4 months.\u003C\/p\u003E\u003Cp id=\u0022p-8\u0022\u003EDr. Lexis and colleagues concluded that metformin (500 mg, BID) started right after PCI in nondiabetic patients does not improve left ventricular diastolic function after STEMI as compared with placebo, both during hospitalization and at 4 months after discharge.\u003C\/p\u003E\u003Cul class=\u0022copyright-statement\u0022\u003E\u003Cli class=\u0022fn\u0022 id=\u0022copyright-statement-1\u0022\u003E\u00a9 2014 MD Conference Express\u00ae\u003C\/li\u003E\u003C\/ul\u003E\u003Cspan class=\u0022highwire-journal-article-marker-end\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Cspan id=\u0022related-urls\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Ca href=\u0022http:\/\/mdc.sagepub.com\/content\/14\/12\/21.1.abstract\u0022 class=\u0022hw-link hw-link-article-abstract\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView Summary\u003C\/a\u003E\u003C\/div\u003E  \u003C\/div\u003E\n\n  \n  \u003C\/div\u003E\n\u003C\/div\u003E\n  \u003C\/div\u003E\n\u003C\/div\u003E\n\u003C\/div\u003E\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/mdc.sagepub.com\/sites\/all\/modules\/highwire\/highwire\/plugins\/highwire_markup_process\/js\/highwire_openurl.js?nzp5pe\u0022\u003E\u003C\/script\u003E\n\u003C\/body\u003E\u003C\/html\u003E"}