Treatment effect of metformin combined with atorvastatin in reducing in-stent restenosis after percutaneous coronary intervention in coronary artery disease patients with type 2 diabetic patients

Medicine (Baltimore). 2022 Oct 14;101(41):e31107. doi: 10.1097/MD.0000000000031107.

Abstract

To investigate the effectiveness of metformin and atorvastatin in preventing in-stent restenosis (ISR) on coronary patients with type 2 diabetes mellitus with percutaneous coronary intervention within 8 to 12 months after rapamycin-eluting stent implantation. A total of 1278 consecutive patients implanted with rapamycin-eluting stent from January 2012 to December 2019, who underwent coronary computed tomography or coronary angiography within 8 to 12 months. The patients were categorized into atorvastatin 20 mg, or atorvastatin 20 mg + metformin 1.5/d, or atorvastatin 40 mg + metformin 1.5/d groups. The clinical characteristics of the 3 groups were compared. The correlation between variables and ISR was analyzed. A total of 701 patients participated in the study. The ratio of ISR/nonstenosis (P = .039) and fasting blood sugar (P = .001) differed significantly in the 3 groups. Logistic regression showed that d, L, different therapeutic agents, and dosage groups were independent risk factors of ISR. The longer L and smaller d may increase ISR incidence with 8 to 12 months after percutaneous coronary intervention. Both metformin and atorvastatin are beneficial in reducing stent restenosis by a dose-dependent manner. An increasing dose of atorvastatin and a combination of metformin decreases the incidence of ISR in patients.

MeSH terms

  • Atorvastatin / therapeutic use
  • Blood Glucose
  • Coronary Angiography / adverse effects
  • Coronary Artery Disease* / surgery
  • Coronary Restenosis* / etiology
  • Coronary Restenosis* / prevention & control
  • Diabetes Mellitus, Type 2* / complications
  • Drug-Eluting Stents* / adverse effects
  • Humans
  • Metformin* / therapeutic use
  • Percutaneous Coronary Intervention* / adverse effects
  • Risk Factors
  • Sirolimus
  • Stents / adverse effects
  • Treatment Outcome

Substances

  • Blood Glucose
  • Metformin
  • Atorvastatin
  • Sirolimus