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Metformin prevented plaque progression in HIV/metabolic syndrome patients
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SEATTLE — Treatment with metformin over 1 year prevented plaque progression in a population of HIV-infected individuals with metabolic syndrome.
“Recent data suggest increased cardiovascular events among patients with HIV, with a 75% increased rate of myocardial infarction compared with non-HIV patients,” Kathleen Fitch, NP, of Massachusetts General Hospital, said during a press conference here.
“Studies have shown that a doubling of plaque is related to a 26% increase in cardiovascular disease events. Cardiac artery calcification is increased in HIV patients, but the effects of lifestyle modifications and metformin have not been evaluated in the HIV population.”
For this reason, Fitch and colleagues conducted a 12-month randomized, placebo-controlled trial to assess lifestyle modification and metformin use, alone and together, among HIV-positive individuals with metabolic syndrome. Primary outcome measure was change in coronary artery calcification score and calcified plaque volume measured by a 64-slice CT scanner. The study included 50 participants, whose fasting lipids, insulin and cardiorespiratory fitness were assessed.
The researchers found that participants who received metformin had significantly less progression of coronary artery calcification during the 12 month period: -1 ± 2 vs. 33 ± 17 (P=.004). They also had less progression in calcified plaque volume: -0.4 ± 1.9 vs. 27.6 ± 13.8 mm3 (P=.008).
Participants who were randomly assigned to lifestyle modifications showed improvement in HDL and cardiorespiratory fitness, but lifestyle modifications showed no significant effect on coronary artery calcification.
“Our results demonstrate that metformin had an effect on plaque progression in patients with HIV and metabolic syndrome,” Fitch said. “Importantly, these data also highlight a 50% rate of plaque progression in the non-treatment group, suggesting a very high rate in the natural history of plaque progression in these patients. In contrast, studies done in the general population regarding plaque progression show that plaque progresses at about half of this rate.”
- Fitch K. #119. Presented at: 19th Conference on Retroviruses and Opportunistic Infections; March 5-8, 2012; Seattle.
Disclosure: Dr. Fitch reports no relevant financial disclosures.