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Background: Thrombolytic therapy is a key in the management of ST elevated myocardial infarction (STEMI). Metformin implies a series of cardioprotective effects. We aimed to investigate how pretreatment with metformin could affect cardiac troponin I (cTnI) levels following reteplase therapy amid STEMI patients. Methods: A pilot randomized clinical trial was carried out in 84 patients with STEMI undergoing thrombolytic therapy with reteplase. The metformin group (n = 42) received a single dose of 1000 mg metformin orally before receiving reteplase, while the control group (n = 42) received only reteplase. The serum level of cTnI was measured at baseline, 8, 16, 24, and 32 hours after the admission to assess myocardial damage. Results: No significant differences were observed in cTnI levels at baseline (p = 0.657), 8 (p = 0.93), 16 (p = 0.690), 24 (p = 0.217), and 32 (p = 0.517) hours after STEMI diagnose between two groups. The mean differences were also not significant for changes of cTnI at baseline and other time frames. Conclusion: The results of the present study indicated that early use of 1000 mg metformin prior to reteplase could not reduce the level of cTnI in STEMI patients.

The impact of metformin on cardiac troponin-I and ST resolution in patients with ST elevation myocardial infarction undergoing thrombolytic therapy