Metformin as a medicine decreasing cardiovascular risk in patients suffering from type 2 diabetes mellitus
DOI:
https://doi.org/10.12775/JEHS.2020.10.08.012Keywords
Metformin, type 2 diabetes mellitus, cardiovascular diseases, myocardial infarction, atherosclerosisAbstract
Almost half of deaths in Poland (approximately 49%) are caused by cardiovascular system diseases. It means that in 2018 it contributed to the death of over two hundred thousand people in our country. Myocardial infarction, stroke and heart failure are the most common of cardiovascular diseases (CVD). The main risk factor for progression of cardiovascular diseases is type 2 diabetes mellitus (T2D). It is estimated that almost 3 million people suffer from T2D in Poland. Metformin is a promising medicine that reduces cardiovascular risk in patients with T2D. It is currently used as the first line drug in patients suffering from T2D. The aim of the presented article is to review current research on the effectiveness of the metformin as a medicine that reduces cardiovascular risk in patients with T2D. Metformin is the oldest and most commonly used medicine that reduces the concentration of glucose in the peripheral blood in patients with T2D. Due to its very good safety profile, low cost and high effectiveness, metformin is used in the first-line treatment for T2D. Recent studies indicate its protective effect by vasodilation, reducing the size of myocardial infarction, inhibiting apoptosis of cardiomyocytes or reducing oxidative stress. Currently, metformin can be seen to have a great potential in the treatment of cardiovascular complications occurring in the course of T2D. Despite the fact that this medicine has been on the market for many years, the studies on its cardioprotective effects have been carried out for a relatively short period of time. It is possible that the detailed understanding of all mechanisms of action of metformin will lead to future advances in the treatment of not only T2D, but also cardiovascular and cancer diseases.References
Sekcja Niewydolności Serca Polskiego Towarzystwa Kardiologicznego. Niewydolność serca w Polsce – raport 2016. http://www.niewydolnosc-serca.pl/barometr.pdf.
Einarson TR, Acs A, Ludwig C, et al. Prevalence of cardiovascular disease in type 2 diabetes: a systematic literature review of scientific evidence from across the world in 2007–2017. Cardiovasc Diabetol. 2018; 17(1): 83. doi:10.1186/s12933-018-0728-6.
Fox C, Golden S, Anderson C, et al. Update on Prevention of Cardiovascular Disease in Adults With Type 2 Diabetes Mellitus in Light of Recent Evidence: A Scientific Statement From the American Heart Association and the American Diabetes Association. Diabetes Care. 2015; 38(9): 1777-1803.
Newman J, MD, Schwartzbard A, Weintraub H, et al. Primary Prevention of Cardiovascular Disease in Diabetes Mellitus, J Am Coll Cardiol. 2017; 70(7): 883–893.
Einarson TR, Acs A, Ludwig C, et al. Economic Burden of Cardiovascular Disease in Type 2 Diabetes: A Systematic Review. Value Health. 2018; 21(7): 881-890.
Ezzati M, Obermeyer Z, Tzoulaki I, et al. The contributions of risk factor trends and medical care to cardiovascular mortality trends, Nat Rev Cardiol. 2015; 12(9): 508–530.
Schernthaner G, Lotan C, Baltadzhieva-Trendafilova E, et al. Unrecognised cardiovascular disease in type 2 diabetes: is it time to act earlier?. Cardiovasc Diabetol. 2018; 17(1): 145.
Strawbridge RJ, van Zuydam NR. Shared Genetic Contribution of Type 2 Diabetes and Cardiovascular Disease: Implications for Prognosis and Treatment, Current Diabetes Reports 2018; 18(8): 59.
Gajos G. Diabetes and cardiovascular disease: from new mechanisms to new therapies, Polish Archives of Internal Medicine. 2018; 128(3): 178-186.
Bailey CJ. Metformin: historical overview. Diabetologia. 2017; 60(9): 1566-1576.
Sanchez-Rangel E, Inzucchi SE. Metformin: clinical use in type 2 diabetes. Diabetologia. 2017; 60(9): 1586-1593.
Diabetes Prevention Program Research Group. Long-term safety, tolerability, and weight loss associated with metformin in the Diabetes Prevention Program Outcomes Study. Diabetes Care. 2012; 35(4): 731-737.
Holstein A, Stumvoll M. Contraindications can damage your health--is metformin a case in point?. Diabetologia. 2005; 48(12): 2454-2459.
Imam TH. Changes in metformin use in chronic kidney disease. Clin Kidney J. 2017; 10(3): 301-304.
Inzucchi, SE, Lipska, KJ, Mayo H, et al. Metformin in patients with type 2 diabetes and kidney disease: a systematic review. JAMA. 2014; 312(24): 2668–2675.
Minamii T, Nogami M, Ogawa W. Mechanisms of metformin action: In and out of the gut. J Diabetes Investig. 2018; 9(4): 701-703.
Spiering MJ. The mystery of metformin. J Biol Chem. 2019; 294(17): 6689-6691.
Rena G, Hardie DG, Pearson ER. The mechanisms of action of metformin. Diabetologia. 2017; 60(9): 1577-1585.
Aroda VR, Knowler WC, Crandall JP, et al. Metformin for diabetes prevention: insights gained from the Diabetes Prevention Program/Diabetes Prevention Program Outcomes Study. Diabetologia. 2017; 60(9): 1601-1611.
Nesti L, Natali A. Metformin effects on the heart and the cardiovascular system: A review of experimental and clinical data. Nutr Metab Cardiovasc Dis. 2017; 27(8): 657-669.
Zilov AV, Abdelaziz SI, AlShammary A, et al. Mechanisms of action of metformin with special reference to cardiovascular protection. Diabetes Metab Res Rev. 2019;35(7):e3173. doi: 10.1002/dmrr.3173.
Pryor R, Cabreiro F. Repurposing metformin: an old drug with new tricks in its binding pockets. Biochem J. 2015; 471(3): 307-322.
Luo F, Das A, Chen J, et al. Metformin in patients with and without diabetes: a paradigm shift in cardiovascular disease management. Cardiovasc Diabetol. 2019; 18(1): 54.
Hesen NA, Riksen NP, Aalders B, et al. A systematic review and meta-analysis of the protective effects of metformin in experimental myocardial infarction. PLoS One. 2018; 13(4): e0195858. doi: 10.1371/journal.pone.0183664.
Dziubak A, Wójcicka G, Wojtak A, et al. Metabolic Effects of Metformin in the Failing Heart. Int J Mol Sci. 2018; 19(10): 2869. doi: 10.3390/ijms19102869.
Downloads
Published
How to Cite
Issue
Section
License
The periodical offers access to content in the Open Access system under the Creative Commons Attribution-NonCommercial-ShareAlike 4.0
Stats
Number of views and downloads: 585
Number of citations: 0