Evaluation of the effect of metformin on cardiac troponin-I and ST_resolution in STEMI patients treated with thrombolytic therapy

Abstract

Background: Studies have shown that Acute Myocardial Infarction (AMI) is one of the leading causes of death and the increase in cardiac biomarkers is significantly associated with mortality. Prompt initaion of treatment of ischemia is one of the major concerns in the early hours of AMI. Therefore, protection of the heart against the ischemia and subsequent increase of biomarkers is considered one of the important goals. Considering the potential effects of metformin on ischemic heart disease, this study was designed to evaluate the effects of metformin on improving the effects of ischemia in patients with AMI.

Objectives: To evaluate the effect of metformin on cardiac biomarkers troponin I and ST_resolution in myocardial infarction in patients undergoing thrombolytic therapy.

Methods: This study was performed as a prospective, randomized, pilot clinical trial at Shahid Madani Heart Center, the largest cardiovascular center in northwestern Iran. The patients were randomly assigned to two groups, Intervention group (n=40) received 1000 mg metformin before reteplase injection and control group (n=40) only received the standard treatment. To assess myocardial damage, serum concentrations of troponin I was measured at baseline, 8, 16, 24 and 32 hours after procedure. This study has been registered in International Clinical Trials Registry Platform (ICTRP) (by irct. ir) with identifier IRCT20111206008307N34.

Result: There were no significant differences in troponin I levels at baseline (p=0.657), 8 (p=0.930), 16 (p=0.690), 24 (p=0.217) and 32 hours (P=0.517) between metformin and control group.

Conclusion: This study did not support the potential cardioprotective effect of pre-treatment with metformin against myocardial injury in patients with STEMI undergoing thrombolytic therapy.