Does Metformin have an Effect on Stent Patency Rates?
Pavel Kibrik, DO, Tereza Izakovich, Jesse VIctory, Matthew A. Goldstein, Christina M. Monteleone, Christina M. Monteleone, Ahmad Alsheekh, Anil Hingorani, MD, Enrico Ascher, MD.
Total Vascular Care, brooklyn, NY, USA.
Objectives: Research has shown that metformin has a protective effect on endothelium. We hypothesize that metformin will decrease re-stenosis/re-intervention rates in patients receiving lower extremity arterial stents.
Methods: 187 patients from October 2012 to December 2015 received an arterial stent in the SFA and/or popliteal artery. Patients were broken down into three groups: non-diabetics(94), diabetics not on metformin(43) and diabetics on metformin(50) and compared against each other for re-stenosis(>60%) rates, limb loss rates, and re-intervention rates. Patients smoking statuses were also considered. Duplex checks were performed one week after the procedure, every three months for the first year after the procedure, followed by every six months. Multivariate analysis was performed.
Results: Average length of follow-up was 13.3 ± 9.6 months. Of the patients on metformin, 24 had no re-stenosis, 34 had no re-intervention, 26 had re-stenosis and 16 had re-intervention. Of the patients who were diabetic but not on metformin, 27 had no re-stenosis, 32 had no re-intervention, 16 had re-stenosis and 11 had re-intervention. Of the patients who did not have diabetes, 57 had no re-stenosis, 64 had no re-intervention, 37 had re-stenosis and 30 had re-intervention. No patients had limb loss. There were no statistically significant differences between any of the three groups and their limb loss, re-stenosis, re-intervention rates, or smoking status.
Conclusions: Despite having multiple proven effects in improving certain clinical outcomes and a proven protective effect on endothelium, metformin does not appear to reduce re-stenosis or re-intervention rates in patients receiving lower extremity arterial stents.
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