Metformin does not improve heart function in patients without diabetes

Although some research has suggested that metformin, a medication often used in the treatment of diabetes, may have favorable effects on ventricular (heart) function, among patients without diabetes who underwent percutaneous coronary intervention (PCI; a procedure such as stent placement used to open narrowed coronary arteries) for ST-segment elevation myocardial infarction (STEMI; a certain pattern on an electrocardiogram following a heart attack), treatment with metformin did not result in improved ventricular function, according to a JAMA study released online to coincide with its presentation at the 2014 American College of Cardiology Scientific Sessions.

Treatment for STEMI includes immediate treatment with anticlotting medications and PCI to restore . STEMI results in left ventricular dysfunction (decreased pump function) in up to 50 percent of patients, and approximately 20 percent to 40 percent of patients develop heart failure sometime after STEMI; heart failure after STEMI is associated with a 3 to 4 times higher risk of death. Left ventricular dysfunction is regarded as the strongest predictor for adverse outcome after STEMI, according to background information in the article.

Chris P. H. Lexis, M.D., of the University of Groningen, Groningen, the Netherlands, and colleagues randomly assigned 380 patients who underwent PCI for STEMI to receive hydrochloride or placebo twice daily for 4 months to determine whether metformin helps preserve left ventricular function after STEMI in patients without diabetes. Left ventricular ejection fraction (a measure of how well the left ventricle of the heart pumps blood with each contraction) was assessed by magnetic resonance imaging.

Left ventricular ejection fraction 4 months after beginning the study did not differ between the metformin group (53.1 percent) and the placebo group (54.8 percent). In addition, N-terminal pro-brain natriuretic peptide level (a cardiac biomarker) was not different between the 2 groups.

Major adverse cardiac events were observed in 6 patients (3.1 percent) in the metformin group and in 2 patients (1.1 percent) in the .

"Because function is currently regarded as the most important predictor of morbidity and mortality after STEMI, it is unlikely that metformin will have a significant effect on long-term outcome after STEMI in patients without diabetes," the authors write.

"The present findings do not support the use of metformin in this setting."

More information: DOI: 10.1001/jama.2014.3315

add to favorites email to friend print save as pdf

Related Stories

AHA: Allogeneic stem cells OK in ischemic cardiomyopathy

Nov 07, 2012

(HealthDay)—For patients with ischemic cardiomyopathy (ICM), allogeneic bone marrow-derived mesenchymal stem cells (MSCs) are safe; and delivery of bone marrow mononuclear cells (BMC) to patients with ST-segment ...

White blood cell count predicts infarct size in STEMI

Dec 19, 2013

(HealthDay)—For patients with anterior wall ST-segment elevated myocardial infarction (STEMI), elevated white blood cell count (WBCc) on presentation is associated with increased infarct size, according ...

Recommended for you

Exercise may protect older women from irregular heartbeat

9 hours ago

Increasing the amount or intensity of physical activity can cut the chances of older women developing a life-threatening irregular heartbeat, according to new research in the Journal of the American Heart Association (JAHA).

Huge discrepancies on heart disease in Europe

20 hours ago

Russians and Ukrainians aged 55 to 59 die from coronary heart disease at a higher rate than Frenchmen who are 20 years older, a study released Wednesday of Europe's cardiovascular health showed.

Common antibiotic linked with heart deaths

Aug 19, 2014

The antibiotic clarithromycin—widely used for treating common bacterial infections—is associated with an increased risk of heart deaths, finds a study published in the BMJ today.

User comments