Metformin does not improve heart function in patients without diabetes

March 31, 2014

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."

Explore further: AHA: Allogeneic stem cells OK in ischemic cardiomyopathy

More information: DOI: 10.1001/jama.2014.3315

Related Stories

AHA: Allogeneic stem cells OK in ischemic cardiomyopathy

November 7, 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 elevation ...

In STEMI, hyperglycemia tied to larger myocardial area-at-risk

March 8, 2014
(HealthDay)—For patients with ST-segment elevation myocardial infarction (STEMI), hyperglycemia is associated with larger area-at-risk and infarct size, and the effect of exenatide treatment is independent of glucose levels, ...

White blood cell count predicts infarct size in STEMI

December 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 to a study published ...

Prior cardiac surgery does not mean worse outcomes for STEMI patients who receive stent

October 23, 2012
Contrary to previous data, patients with prior open heart surgery, or coronary artery bypass graft surgery (CABG), who have a severe heart attack (STEMI) and receive a coronary stent have similar outcomes to patients without ...

Bone marrow mononuclear stem cells show no new gains in heart function, says TIME study

November 18, 2013
New data reported by the Cardiovascular Cell Therapy Research Network (CCTRN) at the 2013 Scientific Sessions of the American Heart Association in Dallas showed that the use of bone marrow mononuclear stem cells (BMCs) did ...

Coronary angioplasty improves cardiac arrest survival

October 20, 2012
Coronary angioplasty improves survival in all patients with out of hospital cardiac arrest, according to research presented at the Acute Cardiac Care Congress 2012. The study was presented by Dr Annamaria Nicolino from the ...

Recommended for you

Laser device placed on the heart identifies insufficient oxygenation better than other measures

September 20, 2017
A new device can assess in real time whether the body's tissues are receiving enough oxygen and, placed on the heart, can predict cardiac arrest in critically ill heart patients, report researchers at Boston Children's Hospital ...

Metabolism switch signals end for healing hearts

September 19, 2017
Researchers have identified the process that shuts down the human heart's ability to heal itself, and are now searching for a drug to reverse it.

Beta blockers not needed after heart attack if other medications taken

September 18, 2017
A new study from the University of North Carolina at Chapel Hill finds beta blockers are not needed after a heart attack if heart-attack survivors are taking ACE inhibitors and statins. The study is the first to challenge ...

Which single behavior best prevents high blood pressure?

September 15, 2017
(HealthDay)—You probably already know that certain healthy lifestyle behaviors can reduce your risk of developing high blood pressure, but is any one behavior more important than the others?

RESPECT trial shows closing a small hole in heart may protect against recurrent stroke

September 13, 2017
A device used to close a small hole in the heart may benefit certain stroke patients by providing an extra layer of protection for those facing years of ongoing stroke risk, according to the results of a large clinical trial ...

Study shows so-called 'healthy obesity' is harmful to cardiovascular health

September 11, 2017
Clinicians are being warned not to ignore the increased cardiovascular health risks of those who are classed as either 'healthy obese' or deemed to be 'normal weight' but have metabolic abnormalities such as diabetes.

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.