A randomized controlled trial of metformin on left ventricular hypertrophy in patients with coronary artery disease without diabetes: the MET-REMODEL trial.
Aged
Body Weight
/ drug effects
Coronary Artery Disease
/ complications
Female
Heart Ventricles
/ physiopathology
Humans
Hypertrophy, Left Ventricular
/ complications
Hypoglycemic Agents
/ adverse effects
Insulin Resistance
Male
Metformin
/ adverse effects
Middle Aged
Oxidative Stress
/ drug effects
Prediabetic State
/ complications
Treatment Outcome
Oxidative stress
Coronary artery disease
Insulin resistance
Left ventricular mass
Metformin
Pre-diabetes
Journal
European heart journal
ISSN: 1522-9645
Titre abrégé: Eur Heart J
Pays: England
ID NLM: 8006263
Informations de publication
Date de publication:
01 11 2019
01 11 2019
Historique:
received:
28
11
2018
revised:
01
02
2019
accepted:
02
04
2019
pubmed:
18
4
2019
medline:
21
10
2020
entrez:
18
4
2019
Statut:
ppublish
Résumé
We tested the hypothesis that metformin may regress left ventricular hypertrophy (LVH) in patients who have coronary artery disease (CAD), with insulin resistance (IR) and/or pre-diabetes. We randomly assigned 68 patients (mean age 65 ± 8 years) without diabetes who have CAD with IR and/or pre-diabetes to receive either metformin XL (2000 mg daily dose) or placebo for 12 months. Primary endpoint was change in left ventricular mass indexed to height1.7 (LVMI), assessed by magnetic resonance imaging. In the modified intention-to-treat analysis (n = 63), metformin treatment significantly reduced LVMI compared with placebo group (absolute mean difference -1.37 (95% confidence interval: -2.63 to -0.12, P = 0.033). Metformin also significantly reduced other secondary study endpoints such as: LVM (P = 0.032), body weight (P = 0.001), subcutaneous adipose tissue (P = 0.024), office systolic blood pressure (BP, P = 0.022) and concentration of thiobarbituric acid reactive substances, a biomarker for oxidative stress (P = 0.04). The glycated haemoglobin A1C concentration and fasting IR index did not differ between study groups at the end of the study. Metformin treatment significantly reduced LVMI, LVM, office systolic BP, body weight, and oxidative stress. Although LVH is a good surrogate marker of cardiovascular (CV) outcome, conclusive evidence for the cardio-protective role of metformin is required from large CV outcomes trials.
Identifiants
pubmed: 30993313
pii: 5470456
doi: 10.1093/eurheartj/ehz203
pmc: PMC6823615
doi:
Substances chimiques
Hypoglycemic Agents
0
Metformin
9100L32L2N
Types de publication
Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
3409-3417Subventions
Organisme : Chief Scientist Office
ID : ETM/352
Pays : United Kingdom
Organisme : Medical Research Council
ID : G0701592
Pays : United Kingdom
Organisme : Chief Scientist Office
ID : PCL/17/07
Pays : United Kingdom
Organisme : British Heart Foundation
ID : PG/14/4/30539
Pays : United Kingdom
Organisme : British Heart Foundation
ID : PG/16/32/32132
Pays : United Kingdom
Commentaires et corrections
Type : CommentIn
Informations de copyright
© The Author(s) 2019. Published by Oxford University Press on behalf of the European Society of Cardiology.
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