The Myocardial Infarction and New Treatment With Metformin Study (MIMET) - a R-RCT to Study Metformin and the Prevention of Cardiovascular Events in Patients With Acute Myocardial Infarction and Newly Detected Prediabetes
Prediabetes is associated to an increased risk of cardiovascular disease and mortality. Although metformin can delay progression to diabetes there is a lack of RCTs evaluating the effect of metformin on cardiovascular outcomes. MIMET aims to investigate if addition of metformin to standard care has effects on the occurrence of cardiovascular events after acute myocardial infarction in patients with newly detected prediabetes (identified by oral glucose tolerance test, HbA1c or fasting glucose levels).
⁃ I. AMI
⁃ II. Swedish citizens with a personal ID number ≥18 years and ≤80 years
⁃ III. Newly diagnosed prediabetes:
• HbA1c 42-47 mmol/mol or
• Capillary or venous fasting plasma glucose concentration 6.1-6.9 mmol/L or
• 2-hour post-load capillary glucose concentration 8.9-12.1 mmol/L or
• 2-h post-load venous plasma glucose concentration 7.8-11.0 mmol/L
• HbA1c \<48 mmol/mol and 2-hour post-load capillary glucose concentration \>12.1 mmol/L or 2-h post-load venous plasma glucose concentration \>11.0 mmol/L (thus elevated 2-hour glucose levels in the diabetes range but without HbA1c levels diagnostic for diabetes)
⁃ IV. Naïve to metformin and other glucose lowering therapy
⁃ V. Signed informed consent