Metformin ‘reduces’ risk of heart disease in non-diabetic patients

A study by the University of Dundee suggests that metformin has the potential to be repurposed as a heart disease treatment in non-diabetic patients.

“Metformin could offer hope for millions of patients across the globe”

Chim Lang

The MET-REMODEL Trial found the drug, used to treat type 2 diabetes for the last 60 years, reduced left ventricular hypertrophy (LVH) in patients with pre-diabetes and pre-existing heart disease.

The researchers behind the trial, published in the European Heart Journal, noted that LVH was often a silent symptom and most patients did not know they had it prior to experiencing a heart attack or stroke.

They highlighted that large studies have previously shown that patients with LVH are at higher risk of adverse cardiovascular events and reducing LVH can substantially reduce mortality rates.

The study involved treating pre-diabetic patients with coronary artery disease with metformin or a placebo over a period of 12 months to see how the drug affected the heart muscle wall, using state-of-the-art MRI technology.

The major causes of LVH are high blood pressure, obesity and insulin resistance, which are also thought to be key contributors of coronary artery disease, noted the researchers.

They found that the dangerous thickening of the left ventricle was reduced by twice as much in those taking metformin compared to the placebo.

They also found that metformin reduced blood pressure, oxidative stress and lost body weight – an average of 3.6 kg, compared to no changes in the placebo group.

The MET-REMODEL trial, funded by the British Heart Foundation, is the first clinical trial in the world to show that metformin could reverse harmful thickening heart muscle wall in a clinical trial.

“This drug is already approved and well tolerated with minimal side effects”

Mohapradeep Mohan

Repurposing cheap and readily available drugs, such as metformin, to treat other health conditions could potentially save the NHS billions of pounds every year.

Lead study author Professor Chim Lang said: “If the findings from this study are substantiated in a larger-scale study, metformin could offer hope for millions of patients across the globe.”

He added: We have previously shown that metformin can have beneficial effects in patients with cardiovascular diseases.

“But this is the first time anyone has looked specifically at the effects of metformin on LVH in nondiabetic patients with coronary artery disease in a clinical trial,” he said.

Mohapradeep Mohan, lead author and principal investigator of the trial, said hypertension drugs were the standard treatment for LVH but warned that this approach was “not particularly effective”.

“In this context, we need non-blood pressure medication and we had good reason to suppose that metformin should help to reduce thickening of heart muscle wall,” he said.

“From the standpoint of clinical practice, this drug is already approved and well tolerated with minimal side effects,” he added.

“If our findings are backed up by bigger studies, using metformin to target LVH presents a novel treatment option and unique opportunity for a quicker translation to the clinic,” he said.