Metformin Reduces Left Ventricular Mass in Patients With Ischemic Heart Disease

Wuhan General Hospital of Guangzhou Military Command120 enrolled

Overview

Cardiovascular disease is the most common cause of death in the world. Most of the attention in treating ischemic heart disease (IHD) is understandably directed toward treating coronary artery disease. However there are other treatable culprits in these patients. Left ventricular hypertrophy (LVH) is widespread in IHD patients, even in the absence of hypertension. It is a strong predictor of cardiovascular events and all-cause mortality. In one study, the presence of LVH was a stronger predictor of mortality than either multivessel cor-onary disease or impaired LV function. Metformin is an antihyperglycemic agent with a history of successful use in type 2 diabetes. In the UKPDS (United Kingdom Prospective Diabetes Study), metformin was associated with a 39% lower risk of myocardial infarction compared with conventional therapy. Metformin also offered dual benefits of improving vascular function and lessening ischemia in nondiabetic patients. Hence, the main aim of this study was to assess whether metformin could regress LVM in patients with IHD. The secondary aim was to assess the effect of metformin on LV volumes and endothelial function in this patient group.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

PREVENTION

Masking

DOUBLE

Enrollment

120

Conditions

Left Ventriclar Mass

Interventions

Eligibility

Sex: ALLMin age: 40 YearsMax age: 70 Years

Medical Language ↔ Plain English

Inclusion Criteria: * They had to have normal glucose tolerance. * They had to have either angiographically documented coronary artery disease or a previous history of myocardial infarction. * They were required to have an office BP \< 130/80 mm Hg * The presence of LVH on echocardiography (American Society of Echocardiography criteria LVM index \[LVMI\] \> 115 g/m2 for men and \> 95 g/m2 for women). Exclusion Criteria: * They were currently prescribed metformin. * They had renal and liver dysfunction, heart failure, or malignancy, or were unable to give informed consent. * Patients with contraindications to cardiac magnetic resonance (CMR) (pacemakers, claustrophobia) were also excluded, as were pregnant or lactating women.

Outcomes

Primary Outcomes

Left ventricular mass.

We will measure left ventricular mass before and after metformin intervention with cardiac magnetic resonance.

Time frame: one year

Secondary Outcomes

Left ventricular volume and endothelial function.

We measure the left ventricular volume and endothelial function before and after metformin intervention by cardiac magnetic resonance and high resolution ultrasound.