Abstract 18926: Metformin is Associated With Improved Skeletal Muscle Glucose Uptake and Improves Skeletal Muscle Energetics. There is Limited Data of the Impact of Metformin Us on Need for Repeat Revascularization in Patients With Symptomatic Peripheral Artery Disease (pad) Treated With Endovascular Revascularization

Abstract

Background: Metformin is associated with improved skeletal muscle glucose uptake and improves skeletal muscle energetics. There is limited data of the impact of metformin us on need for repeat revascularization in patients with symptomatic peripheral artery disease (PAD) treated with endovascular revascularization. Methods: We compared need for vessel revascularization (TLR) rates in patients with diabetes mellitus (DM) treated with metformin and without, to non-DM enrolled in the Excellence in Peripheral Artery Disease (XLPAD) registry (NCT01904851) between 2006 and 2015. Results: In the study cohort of 2140 interventional procedures, 57.4% were performed in DM (n=268 on metformin and n=961 not on metformin). Frequency of hypertension, hyperlipidemia and chronic kidney disease was higher in DM not on metformin compared to DM on metformin (p<0.001 for all comparisons). Lesion and stent lengths were similar in both groups. Revascularization free survival compared to the non-DM (control) was similar for DM on metformin (HR=0.95, 95%CI: 0.56-1.60; p=0.85) compared to DM not on metformin (HR=1.84, 95%CI: 0.98-3.45; p=0.06; Figure 1A). Overall survival compared to non-DM (control), was similar for DM on metformin (HR=1.70, 95%CI: 0.64-4.54; p=0.29) and significantly worse for DM not on metformin (HR=4.55, 95%CI: 2.44-8.48; p<0.001; Figure 1B). Conclusions: Metformin therapy in symptomatic PAD patients with DM following endovascular revascularization is associated with improved survival and lower need for repeat revascularization compared to diabetics not treated with metformin.