Which medication should be held prior to a cardiac catheterization procedure?

In the context of a cardiac catheterization procedure, it is essential to consider the effects of medications on the risk of bleeding and kidney function. Metformin, which is an oral hypoglycemic agent used to control blood sugar levels in patients with type 2 diabetes, is typically held prior to such procedures due to concerns about renal function and the risk of lactic acidosis.

During a cardiac catheterization, contrast dye is often used, which can potentially compromise kidney function, particularly in patients who already have some degree of renal impairment. If a patient is on metformin and experiences a decline in renal function after exposure to contrast media, there is a risk that metformin could accumulate in the body, leading to serious complications like lactic acidosis. Therefore, it is standard practice to withhold metformin before the procedure and resume it afterward when the patient’s renal function is confirmed to be stable.

The other medications mentioned serve different roles. Aspirin is an antiplatelet agent that is often continued to reduce the risk of thrombus formation during the procedure. Warfarin, an anticoagulant, may be managed with specific protocols regarding bridging therapy depending on the patient's risk factors and the urgency of the procedure, while statins generally do not require