Insulin Sensitization Therapy May Cut MIs in Diabetics

Compared to use of sulfonylurea alone, the insulin-sensitizing drugs metformin and the thiazolidinediones appear to reduce the risk of myocardial infarction in patients with diabetes. Senior investigator Dr. Stephen E. Kimmel stated that, The study suggests that this approach "may have cardiovascular benefits with respect to heart attacks, but further research is needed, preferably randomized trials."

Dr. Kimmel of the University of Pennsylvania, Philadelphia and colleagues note that to investigate whether certain drugs might have cardiovascular advantages, they conducted a study of first MI in diabetics in the Philadelphia area over a period of 56 months.
Each such patient was matched with about 4 diabetic controls from the same area.

After adjustment, compared to monotherapy with sulfonylurea, such use of thiazolidinediones yielded an odds ratio for MI of 0.33. For metformin, the corresponding ratio was 0.48.

Furthermore, addition of thiazolidinediones, but not metformin, to sulfonylurea monotherapy led to a significant reduction in MI risk.
However, as well as requiring further research, concluded Dr. Kimmel, "the potential benefit of these drugs must be balanced against their potential side effects – such as the potential for worsening of heart failure with thiazolidinediones."
Am J Cardiol 2006;97:651-654