Metformin is the most widely used type 2 diabetes drug, and is known as a “magic medicine” because of its anti-cancer and anti-aging effects. Now, scientists from the University of Dundee in the UK have recently discovered that metformin can also reverse the thickening of harmful myocardial walls that cause cardiovascular disease. The results of relevant clinical trials were published on April 17th in the European Heart Journal, the top journal in the cardiovascular field (latest impact factor 23.425).
The test, code-named MET-REMODEL, tested the hypothesis that metformin might reverse left ventricular hypertrophy (LVH, left ventricular wall thickening) in patients with coronary heart disease (CAD) with insulin resistance and/or pre-diabetes.
The trial randomized 68 patients (mean age 65 ± 8 years) who received metformin XL (Metformin XL, 2000 mg daily) or placebo for 12 months. The primary endpoint was to assess changes in left ventricular mass index (LVMI) by magnetic resonance imaging, which assessed how metformin affects the myocardial wall.
In a modified intention-to-treat analysis (n=63), metformin treatment significantly reduced LVMI compared with placebo, and left ventricular thickening was reduced by a factor of two in patients taking metformin. In addition, the trial also found that metformin reduced blood pressure, oxidative stress, and body weight (average reduction of 3.6 kg). Patients in the placebo group did not change in these areas.
LVH is a serious risk factor for future heart attacks, strokes and heart failure and is usually a silent symptom. Most people don’t know they have LVH before a heart attack or stroke. The main causes of LVH are hypertension, obesity and insulin resistance, which are also considered to be key factors in triggering CAD. Previous large studies have shown that patients with LVH have a higher risk of developing adverse cardiovascular events, and lowering LVH can significantly reduce mortality.
Antihypertensive drugs are the standard treatment for LVH, but this method is not particularly effective, so it is necessary to find new treatments for LVH. MET-REMODEL is the first clinical trial in the world to demonstrate that metformin may be able to reverse the thickening of harmful myocardial walls.
Professor Chim Lang, who led the trial, said cardiovascular disease is the leading cause of death worldwide. Their previous studies have shown that metformin is beneficial for patients with cardiovascular disease. The trial further confirmed that metformin has the potential to improve cardiovascular health and offers the potential to improve patient life expectancy.
In summary, this is the first time a team has conducted a clinical trial to investigate the effects of metformin on LVH in non-diabetic patients with coronary heart disease. Test data suggest that metformin may be useful in the treatment of conditions other than diabetes. If the results of this trial are supported by larger studies, then metformin will be a new option for the treatment of LVH.