Metformin and intravenous contrast

Baerlocher, Mark O.; Asch, Murray; Myers, Andy

doi:10.1503/cmaj.090550

Cited by 28 publications

(13 citation statements)

References 5 publications

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“…Medication review and adjustment is also important for patients with diabetes, and insulin dosing should be adjusted to account for the time that the patient will be NPO. Metformin should be held on the day of the procedure and for 48 hr afterward [17,27].…”

Section: Patient Preparation Within 48 Hr and Immediatementioning

confidence: 99%

SCAI expert consensus statement: 2016 best practices in the cardiac catheterization laboratory: (Endorsed by the cardiological society of india, and sociedad Latino Americana de Cardiologia intervencionista; Affirmation of value by the Canadian Association of interventional cardiology–Association canadienne de cardiologie d'intervention)*

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et al. 2016

Cathet Cardio Intervent

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Section: Patient Preparation Within 48 Hr and Immediatementioning

confidence: 99%

SCAI expert consensus statement: 2016 best practices in the cardiac catheterization laboratory: (Endorsed by the cardiological society of india, and sociedad Latino Americana de Cardiologia intervencionista; Affirmation of value by the Canadian Association of interventional cardiology–Association canadienne de cardiologie d'intervention)*

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“…Contrast induced nephropathy (CIN) is a term used to describe a sudden deterioration in renal function caused by the intravascular administration of contrast medium. One of the most used criteria for the diagnosis of CIN is an increase of 0.5 mg/dl over baseline serum creatinine [27]. Iodinated contrast media acts as an independent risk factor for developing CIN in patients with a GFR lower than 30 ml/min/1.73 m 2 , but is rarely nephrotoxic in patients with GFR values between 30 and 45 ml/min/1.73 m 2 [28,29].…”

Section: Contrast Induced Nephropathymentioning

confidence: 99%

“…The recommendation is that Metformin should not be stopped for patients with a GFR higher that 60 ml/min/1.73 m 2 . Administration should be stopped for 48 hours only in patients with impaired renal function [27].…”

Section: Patients Undergoing Treatment With Metformin or Metformin-comentioning

confidence: 99%

Contraindications and adverse effects in abdominal imaging

et al. 2019

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Ultrasound (US), computed-tomography (CT) and magnetic resonance imaging (MRI) are the most frequently used imaging techniques in abdominal pathology. US plays a pivotal role in evaluating abdominal disease, sometimes being sufficient for a complete diagnosis and has virtually no contraindications. The usage of US contrast agents will add useful diagnostic information in both hepatic and non-hepatic pathology. CT has, over MRI, the advantage of being readily available. The usage of ionizing radiation is the main pitfall of CT. Allergies and contrast induced nephropathy in patients with an impaired renal function are the major risks of contrast media administration in CT. Its excellent tissue resolution makes MRI a very useful technique in abdominal pathology, the major contraindications being the presence of MRI “unsafe” implants and devices and the presence of metallic foreign bodies, particularly close to vital structures like the eyes or major vessels. Contrast administration in MRI is restricted in patients with renal insufficiency due to the risk of nephrogenic systemic fibrosis. Allergies to MRI contrast media are rare and less important compared to allergies due to CT contrast media

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“…16 A non-significant trend towards reduced allcause mortality was also noted with metformin monotherapy. 16,17 This benefit may be especially pronounced in obese patients with a systematic review trial reporting a reduction in all-cause mortality with metformin in this population when compared with sulfonylurea. [17][18][19][20][21][22] A systematic review of cohort studies found no increased risk for cardiovascular morbidity and mortality with metformin use across various subgroups of patients compared with placebo or insulin.…”

Section: Cardiovascular Safetymentioning

confidence: 99%

“…16,17 This benefit may be especially pronounced in obese patients with a systematic review trial reporting a reduction in all-cause mortality with metformin in this population when compared with sulfonylurea. [17][18][19][20][21][22] A systematic review of cohort studies found no increased risk for cardiovascular morbidity and mortality with metformin use across various subgroups of patients compared with placebo or insulin. 30,31 Thus metformin has an excellent cardiovascular safety profile along with low cost and efficacy and guidelines recommend metformin as the first-line drug therapy of choice for type 2 DM.…”

Section: Cardiovascular Safetymentioning

confidence: 99%

Cardiovascular safety of oral antidiabetic therapy in type 2 diabetes mellitus- review article

et al. 2017

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Cardiovascular disease is the leading cause of morbidity and mortality among patients with type 2 diabetes mellitus (DM). There is twofold increased risk of cardiovascular (CV) mortality among diabetic patients as compared with nondiabetic patients. The glycemic efficacy of anti-diabetic drugs does not necessarily provide cardiovascular safety. Since 2008, US Food and Drug Administration has recommended that new drugs for type 2 DM should undergo clinical trials to demonstrate cardiovascular safety in addition to glycemic benefit. In 2012, European medicine agencies issued a similar recommendation. In this review, we have tried to examine the cardiovascular safety of oral antidiabetic agents in major published trials. Metformin remains the initial drug of choice in type2 DM till date. The sulfonylureas, one of oldest oral anti-diabetic drugs, have adverse cardiovascular events and are gradually being out classed by other second line drugs. The glitazones have been found to have adverse outcome in heart failure. The incretin based drugs have been found to have cardiovascular safety in various trials in recent past and their performances have been reassuring. There is lack of enough cardiovascular outcome data for meglitinides and glucosidase inhibitors. Various current trials have found sodium glucose cotransporter-2 inhibitors to have a potential for cardiovascular benefit. Careful selection of drug therapy with special attention for cardiovascular risk is important in selection and optimization of diabetic therapy.

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Metformin and intravenous contrast

Cited by 28 publications

References 5 publications

Contraindications and adverse effects in abdominal imaging

Cardiovascular safety of oral antidiabetic therapy in type 2 diabetes mellitus- review article

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