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Latest Update on Metformin
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<blockquote data-quote="Nelson Vergel" data-source="post: 57650" data-attributes="member: 3"><p>PLoS One. 2016; 11(1): e0145719.</p><p>Published online 2016 Jan 25. doi: 10.1371/journal.pone.0145719</p><p>PMCID: PMC4726568</p><p></p><p><strong>Effect of Metformin Treatment on Lipoprotein Subfractions in Non-Diabetic Patients with Acute Myocardial Infarction: A Glycometabolic Intervention as Adjunct to Primary Coronary Intervention in ST Elevation Myocardial Infarction (GIPS-III) Trial</strong></p><p><strong></strong></p><p>Ruben N. Eppinga,1 Minke H. T. Hartman,1 Dirk J. van Veldhuisen,1 Chris P. H. Lexis,1 Margery A. Connelly,2 Erik Lipsic,1 Iwan C. C. van der Horst,3 Pim van der Harst,1,* and Robin P. F. Dullaart4</p><p>Giacomo Frati, Editor</p><p></p><p>1University of Groningen, University Medical Center Groningen, the Department of Cardiology, Groningen, the Netherlands</p><p>2LabCorp, Raleigh, North Carolina, United States of America</p><p>3University of Groningen, University Medical Center Groningen, the Department of Critical Care, Groningen, the Netherlands</p><p>4University of Groningen, University Medical Center Groningen, the Department of Endocrinology, Groningen, the Netherlands</p><p>Sapienza University of Rome, ITALY</p><p>Competing Interests: The authors of this manuscript have read the journal's policy and have the following competing interests: MAC, PhD is an employee of LabCorp (Raleigh, North Carolina, USA), however this does not alter the authors' adherence to PLOS ONE policies on sharing data and materials.</p><p></p><p></p><p></p><p></p><p>Abstract</p><p></p><p>Objective</p><p></p><p>Metformin affects low density lipoprotein (LDL) and high density (HDL) subfractions in the context of impaired glucose tolerance, but its effects in the setting of acute myocardial infarction (MI) are unknown. We determined whether metformin administration affects lipoprotein subfractions 4 months after ST-segment elevation MI (STEMI). Second, we assessed associations of lipoprotein subfractions with left ventricular ejection fraction (LVEF) and infarct size 4 months after STEMI.</p><p></p><p>Methods</p><p></p><p>371 participants without known diabetes participating in the GIPS-III trial, a placebo controlled, double-blind randomized trial studying the effect of metformin (500 mg bid) during 4 months after primary percutaneous coronary intervention for STEMI were included of whom 317 completed follow-up (clinicaltrial.gov Identifier: NCT01217307). Lipoprotein subfractions were measured using nuclear magnetic resonance spectroscopy at presentation, 24 hours and 4 months after STEMI. (Apo)lipoprotein measures were obtained during acute STEMI and 4 months post-STEMI. LVEF and infarct size were measured by cardiac magnetic resonance imaging.</p><p></p><p>Results</p><p></p><p>Metformin treatment slightly decreased LDL cholesterol levels (adjusted P = 0.01), whereas apoB remained unchanged. Large LDL particles and LDL size were also decreased after metformin treatment (adjusted P<0.001). After adjustment for covariates, increased small HDL particles at 24 hours after STEMI predicted higher LVEF (P = 0.005). In addition, increased medium-sized VLDL particles at the same time point predicted a smaller infarct size (P<0.001).</p><p></p><p>Conclusion</p><p></p><p>LDL cholesterol and large LDL particles were decreased during 4 months treatment with metformin started early after MI. Higher small HDL and medium VLDL particle concentrations are associated with favorable LVEF and infarct size.</p></blockquote><p></p>
[QUOTE="Nelson Vergel, post: 57650, member: 3"] PLoS One. 2016; 11(1): e0145719. Published online 2016 Jan 25. doi: 10.1371/journal.pone.0145719 PMCID: PMC4726568 [B]Effect of Metformin Treatment on Lipoprotein Subfractions in Non-Diabetic Patients with Acute Myocardial Infarction: A Glycometabolic Intervention as Adjunct to Primary Coronary Intervention in ST Elevation Myocardial Infarction (GIPS-III) Trial [/B] Ruben N. Eppinga,1 Minke H. T. Hartman,1 Dirk J. van Veldhuisen,1 Chris P. H. Lexis,1 Margery A. Connelly,2 Erik Lipsic,1 Iwan C. C. van der Horst,3 Pim van der Harst,1,* and Robin P. F. Dullaart4 Giacomo Frati, Editor 1University of Groningen, University Medical Center Groningen, the Department of Cardiology, Groningen, the Netherlands 2LabCorp, Raleigh, North Carolina, United States of America 3University of Groningen, University Medical Center Groningen, the Department of Critical Care, Groningen, the Netherlands 4University of Groningen, University Medical Center Groningen, the Department of Endocrinology, Groningen, the Netherlands Sapienza University of Rome, ITALY Competing Interests: The authors of this manuscript have read the journal's policy and have the following competing interests: MAC, PhD is an employee of LabCorp (Raleigh, North Carolina, USA), however this does not alter the authors' adherence to PLOS ONE policies on sharing data and materials. Abstract Objective Metformin affects low density lipoprotein (LDL) and high density (HDL) subfractions in the context of impaired glucose tolerance, but its effects in the setting of acute myocardial infarction (MI) are unknown. We determined whether metformin administration affects lipoprotein subfractions 4 months after ST-segment elevation MI (STEMI). Second, we assessed associations of lipoprotein subfractions with left ventricular ejection fraction (LVEF) and infarct size 4 months after STEMI. Methods 371 participants without known diabetes participating in the GIPS-III trial, a placebo controlled, double-blind randomized trial studying the effect of metformin (500 mg bid) during 4 months after primary percutaneous coronary intervention for STEMI were included of whom 317 completed follow-up (clinicaltrial.gov Identifier: NCT01217307). Lipoprotein subfractions were measured using nuclear magnetic resonance spectroscopy at presentation, 24 hours and 4 months after STEMI. (Apo)lipoprotein measures were obtained during acute STEMI and 4 months post-STEMI. LVEF and infarct size were measured by cardiac magnetic resonance imaging. Results Metformin treatment slightly decreased LDL cholesterol levels (adjusted P = 0.01), whereas apoB remained unchanged. Large LDL particles and LDL size were also decreased after metformin treatment (adjusted P<0.001). After adjustment for covariates, increased small HDL particles at 24 hours after STEMI predicted higher LVEF (P = 0.005). In addition, increased medium-sized VLDL particles at the same time point predicted a smaller infarct size (P<0.001). Conclusion LDL cholesterol and large LDL particles were decreased during 4 months treatment with metformin started early after MI. Higher small HDL and medium VLDL particle concentrations are associated with favorable LVEF and infarct size. [/QUOTE]
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Latest Update on Metformin
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