Abstract:

Objective To investigate the effect of different doses of metformin on the incidence of contrast⁃induced nephropathy（CIN）after primary percutaneous coronary intervention（PCI）in patients with acute myocardialinfarction（AMI）complicated and type 2 diabetes mellitus（T2DM）. Methods To select 95 patients between January2017 to December 2019 in The First People′s Hospital of Nanning diagnosis of AMI with T2DM，and all of themwere treated primary PCI. They were divided into low⁃dose group（metformin ≤ 1 000 mg/d），the high dose group（metformin > 1 000 mg/d）and the control group（non⁃metformin）according preoperatively. To compare threegroups of patients with clinical data and analyze the risk factors for CIN production by Logistic regression. Results There were no statistically significant differences among the three groups in age，sex，BMI，cardiovascular riskfactors，coronary angiography，cardiovascular medication，hemoglobin a1c（HbA1c），baseline and postoperativecreatinine，estimated glomerular filtration rate（eGFR）（all P > 0.05）. CIN occurred in 7 cases（21.9%）of the low⁃dose group，8 cases（26.7%）of the high⁃dose group，and 7 cases（20.6%）of the control group. The incidencewas slightly higher in the high⁃dose group，but there was no statistically significant difference among three groups（P > 0.05）. Logistic regression analysis showed that age of > 75 years old，preoperative eGFR < 60 mL/min，andcontrast media volum of ≥ 150 mL were risk factors of CIN. Conclusion Patients with AMI and T2DM were treatedprimary PCI，continuous use of metformin by therapeutic doses in preoperative did not increase the incidence ofCIN. The incidence of CIN was not related to the dose of metformin，but to age，eGFR，and contrast media volume.

Key words: acute myocardial infarction, type 2 diabetes mellitus, percutaneous coronary interven?tion, contrast?induced nephropathy