Key result
Metformin therapy linked to ~20% improvement in CFR in women with PCOS and insulin resistance.
Why the study?
Does metformin therapy improve coronary flow reserve in women with polycystic ovary syndrome and insulin resistance?
Does metformin therapy improve coronary flow reserve in women with polycystic ovary syndrome and insulin resistance?
Absolute Event Rate: 3.3% vs 2.75%
p-value: p=0.016
Metformin therapy for 6 months significantly improves coronary microvascular function, as measured by coronary flow reserve, in women with PCOS and insulin resistance.
Metformin was associated with improved coronary flow reserve in PCOS; hypothesis-generating and should not change practice pending randomized confirmation.
BACKGROUND: Women with polycystic ovary syndrome (PCOS) are thought to have increased cardiovascular risk. Metformin therapy reduces whole-body insulin resistance (IR) in patients with type-2 diabetes mellitus (DM). OBJECTIVE: As insulin resistance accompanying PCOS may be reversed by metformin therapy, we hypothesized that metformin therapy might improve coronary microvascular functions in women with PCOS and IR. PATIENTS AND METHODS: We treated 16 women with PCOS and IR with metformin, and measured coronary flow reserve (CFR) at the beginning and after 6 months of metformin therapy using transthoracic second-harmonic Doppler echocardiography. RESULTS: At the end of the 6 months of metformin therapy, baseline coronary diastolic peak flow velocity (DPFV) did not change significantly (from 24.6 +/- 4.3 to 23.0 +/- 3.1, P = 0.106); however, hyperaemic coronary DPFV (from 68.2 +/- 12.7 to 74.5 +/- 9.7, P = 0.08), and CFR (from 2.75 +/- 0.48 to 3.3 +/- 0.5, P = 0.016) was significantly improved by metformin therapy. CONCLUSION: In women with PCOS, coronary microvascular function and CFR are significantly improved by 6 months of therapy with metformin.
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Topçu et al. (2006) studied Polycystic ovary syndrome and insulin resistance (n=16). Metformin vs. Baseline was evaluated on Coronary flow reserve (CFR) (p=0.016). Six months of metformin therapy significantly improved coronary flow reserve from 2.75 at baseline to 3.3 (P=0.016) in women with polycystic ovary syndrome and insulin resistance.