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Metformin may improve CV risk profile in patients at risk for diabetes
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Four months of metformin therapy modestly improved the cardiovascular risk profile in patients with ST-elevation myocardial infarction, or STEMI, at high risk for diabetes.
“HbA1c levels, weight gain, total cholesterol and LDL cholesterol levels were all lower in patients receiving metformin,” the researchers wrote. “A reduction in the incidence of new-onset diabetes was not observed. ... These results imply that metformin might be able to modestly reduce the [CV] risk in patients without diabetes on top of standard care (including statin therapy). Whether these findings are substantial and can lead to a reduction in [CV] events remains to be determined.”
Chris P. H. Lexis, MD, of the University Medical Center Groningen in the Netherlands, and colleagues evaluated 379 patients without diabetes, but at high risk for the disease, presenting with STEMI from the GIPS-III trial to determine the effect of metformin treatment on CV risk profile. Participants were randomly assigned to placebo (n = 174) or metformin 500 mg twice daily (n = 172) for 4 months.
After adjustment for baseline values, slightly lower HbA1c levels were found for the metformin group (5.83%) compared with the placebo group (5.89%) at 4 months; no differences were found for insulin levels.
Twelve percent of the metformin group and 10% of the placebo group were diagnosed with new-onset diabetes at 4 months; after 4 months, 63% of the metformin group and 71% of the placebo group had prediabetes.
After 4 months, BMI (P = .014), body weight (P = .024), total cholesterol (P = .045) and LDL cholesterol (P = .007) were lower in the metformin group compared with the placebo group.
“In patients with acute [MI] at risk for diabetes, 4 months of treatment with metformin on top of optimal treatment resulted in a modestly more favorable [CV] risk profile compared with placebo,” the researchers wrote. “Metformin treatment improved glycemic control and cholesterol levels, and prevented gain in body weight. Whether these favorable effects on risk factors can be translated to improved long-term outcomes requires further study.” – by Amber Cox
Disclosure: Lexis reports no relevant financial disclosures. Please see the full study for a list of all other authors’ relevant financial disclosures.
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