Key result
Insulin treatment in type 2 diabetics post-myocardial infarction was associated with increased risk of non-fatal MI and stroke (HR 1.73; 95% CI 1.26-2.37), whereas metformin was protective.
Why the study?
Does the choice of glucose lowering treatment (metformin, sulphonylureas, or insulin) affect cardiovascular mortality and non-fatal cardiovascular events in patients with type 2 diabetes and recent myocardial infarction?
Population
1181 patients with type 2 diabetes discharged after myocardial infarction, mean age 68 years, 67% male.
Comparison
Glucose lowering treatments including metformin… vs Other glucose lowering treatments
Design
Cohort
Follow-up
median of 2.1 years
Authors
Loading...
Caution against altering therapy based on observational data alone; leaves open whether metformin or insulin affects post-MI cardiovascular events in type 2 diabetes.
Observational (n=1,181)
Does the choice of glucose lowering treatment (metformin, sulphonylureas, or insulin) affect cardiovascular mortality and non-fatal cardiovascular events in patients with type 2 diabetes and recent myocardial infarction?
Hazard Ratio: 1.05 (95% CI 0.75–1.46)
p-value: p=0.77
In a post hoc analysis of post-MI patients with type 2 diabetes, metformin was associated with a reduced risk of non-fatal MI and stroke, while insulin was associated with an increased risk, highlighting the need for randomized trials to confirm these findings.
Mellbin et al. (2007) conducted an observational in Type 2 diabetes and myocardial infarction (n=1,181). Insulin was evaluated on Cardiovascular mortality (HR 1.05, 95% CI 0.75-1.46, p=0.77). Insulin treatment in type 2 diabetics post-myocardial infarction was associated with increased risk of non-fatal MI and stroke (HR 1.73; 95% CI 1.26-2.37), whereas metformin was protective.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: