Metformin therapy in patients with prediabetes and stable angina was associated with lower rates of coronary endothelial dysfunction and MACE at 24 months compared to no metformin (P<0.05).
Cohort (n=258)
Yes
Does metformin therapy improve coronary endothelial function and reduce MACE in patients with prediabetes, stable angina, and nonobstructive coronary artery stenosis?
Metformin therapy may reduce the risk of cardiovascular events and improve coronary endothelial function in patients with prediabetes and nonobstructive coronary artery disease.
p-value: p=<0.05
OBJECTIVE To evaluate the effect of metformin therapy on coronary endothelial function and major adverse cardiac events (MACE) in patients with prediabetes with stable angina and nonobstructive coronary stenosis (NOCS). RESEARCH DESIGN AND METHODS Metformin therapy may be needed to reduce coronary heart disease risk in patients with prediabetes. A total of 258 propensity score–matched (PSM) patients with stable angina undergoing coronary angiography were enrolled in the study. Data from 86 PSM subjects with normoglycemia (NG), 86 PSM subjects with prediabetes (pre-DM), and 86 PSM subjects with prediabetes treated with metformin (pre-DM metformin) were analyzed. During coronary angiography, NOCS was categorized by luminal stenosis 40% and fractional flow reserve 0.80. In addition, we assessed the endothelial function, measuring coronary artery diameter of left anterior descending coronary (LAD) at baseline and after the infusion of acetylcholine, by means of an intracoronary Doppler guide wire. MACE, as cardiac death, myocardial infarction, and heart failure, was evaluated at 24 months of follow-up. RESULTS At baseline, NG patients had a lower percentage of LAD endothelial dysfunction compared with pre-DM patients (P 0.05). The pre-DM patients had a higher percentage of endothelial LAD dysfunction as compared with the pre-DM metformin patients (P 0.05). At the 24th month of follow-up, MACE was higher in pre-DM versus NG (P 0.05). In pre-DM metformin patients, MACE was lower compared with pre-DM patients (P 0.05). CONCLUSIONS Metformin therapy may reduce the high risk of cardiovascular events in pre-DM patients by reducing coronary endothelial dysfunction.
Sardu et al. (2019) conducted a cohort in Prediabetes with stable angina and nonobstructive coronary artery stenosis (n=258). Metformin vs. Prediabetes without metformin was evaluated on Coronary endothelial dysfunction and major adverse cardiac events (cardiac death, myocardial infarction, and heart failure) (p=<0.05). Metformin therapy in patients with prediabetes and stable angina was associated with lower rates of coronary endothelial dysfunction and MACE at 24 months compared to no metformin (P<0.05).