The Relationship Between Metformin And Postcontrast Acute Kidney Injury After Coronary Angiography In Patients With Type 2 Diabetes Mellitus

Objective:This study aims to discuss whether continuing metformin treatment in type 2 di abetes mellitus（T2DM）patients who will undergo coronary angiography（CAG）will result i n post-contrast acute kidney injury（PC-AKI）during their hospital stay and clinical events within one month after their hospital discharge.Methods:This study was strictly designed as a prospective and randomized controlled stud y.In detail,it randomly selected 288 T2DM patients who hospitalized in Vasculocardiology Department in Zhong Da Hospital,Jiangsu during February 2018 and January 2019,planned to undergo CAG,and were with normal or mildly impaired renal functions(e GFR≥45ml·m in^-1·1.73m^-2).The patients were further randomly divided into two groups:146 patients cont inued metformin treatment during the CAG,142 patients discontinued metformin treatment 24 hours before the CAG.The serum creatinine levels of the patients were observed by gro up within 48 to 72 hours after they went through the CAG,and the baseline data and PC-AKI incidence of the two groups were analyzed.A multi-factor logistic regression analysis was performed to figure out the factors that affect the PC-AKI incidence.In addition,clinic al events of the patients within one month after their hospital discharge were observed.Results:8 PC-AKI cases occurred in the metformin continued group,accounting for 5.5%;4PC-AKI cases occurred in the metformin discontinued group,accounting for 2.8%.There was no statistical significance between the two groups（P=0.202）.The multi-factor logistic regression analysis indicated that the age is a major risk factors leading to CIN,while the basic e GFR、hemoglobin、bilirubin are three key factors preventing PC-AKI.In addition,t here was no statistical significance between the two groups considering the clinical events within one month after the hospital discharge.Conclusion:Continuing metformin in T2DM patients who are scheduled for CAG and with normal or mildly impaired renal functions(e GFR≥45ml·min^-1·1.73m^-2)will not increase the incidence of PC-AKI or clinical events after the patients’hospital discharge.