The Pleiotropic Effects of Metformin
The Pleiotropic Effects of Metformin
Type 2 diabetes and its cardiovascular sequelae represent a major global public health challenge. IRI is a major target for intervention in patients suffering STEMI, and may be of particular benefit in diabetic patients who have inflated cardiovascular mortality compared to non-diabetic patients. There is convincing pre-clinical evidence that metformin, given at the time of IRI, may have a cardioprotective role beyond its glucose-lowering effect. However, despite its availability and safety profile, there is a paucity of clinical studies addressing this hypothesis. To repurpose this potentially beneficial therapy to a global population in need of new treatments for STEMI, especially in regions where PPCI is unavailable, well-designed prospective cohort studies of the potential pleiotropic benefits of metformin on cardiovascular disease, and particularly its benefit in ischaemia–reperfusion injury, are essential.
Conclusions
Type 2 diabetes and its cardiovascular sequelae represent a major global public health challenge. IRI is a major target for intervention in patients suffering STEMI, and may be of particular benefit in diabetic patients who have inflated cardiovascular mortality compared to non-diabetic patients. There is convincing pre-clinical evidence that metformin, given at the time of IRI, may have a cardioprotective role beyond its glucose-lowering effect. However, despite its availability and safety profile, there is a paucity of clinical studies addressing this hypothesis. To repurpose this potentially beneficial therapy to a global population in need of new treatments for STEMI, especially in regions where PPCI is unavailable, well-designed prospective cohort studies of the potential pleiotropic benefits of metformin on cardiovascular disease, and particularly its benefit in ischaemia–reperfusion injury, are essential.
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