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Metformin Therapy in Diabetes: The Role of Cardioprotection

  • Coronary Heart Disease (JA Farmer, Section Editor)
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Abstract

In patients with diabetes mellitus, the incidence of cardiovascular disease is increased, and the outcome following cardiovascular events is worse. The antihyperglycemic drug metformin appears to limit cardiovascular death in patients with type 2 diabetes. Indeed, preclinical studies have demonstrated that metformin limits (myocardial) ischemia and reperfusion injury, independent from its glucose-lowering effect. This cardioprotection is mediated by activation of the Reperfusion Injury Salvage Kinase (RISK) pathway, activation of AMPK and by an increased formation of adenosine. In addition, metformin can modulate several cardiovascular risk factors and reduces the development of heart failure in murine models. Consequently, treatment with metformin might potentially improve cardiovascular outcome in patients at risk for myocardial ischemia, even if these patients do not have diabetes. In the current paper, we focus on the direct cardioprotective actions of metformin and the mechanisms that underlie these effects.

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Acknowledgements

This work was financially supported by a grant of the Dutch Heart Foundation (to NPR and GA) and the Netherlands Organisation for Health Research and Development (ZonMW; Clinical Fellowship to NPR).

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Authors and Affiliations

  1. Department of Pharmacology-Toxicology 149, Radboud University Nijmegen Medical Center, PO Box 9101, 6500 HB, Nijmegen, The Netherlands

    Saloua El Messaoudi, Gerard A. Rongen & Niels P. Riksen

  2. Department of General Internal Medicine, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands

    Gerard A. Rongen & Niels P. Riksen

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  1. Saloua El Messaoudi
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  2. Gerard A. Rongen
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  3. Niels P. Riksen
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Correspondence to Niels P. Riksen.

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El Messaoudi, S., Rongen, G.A. & Riksen, N.P. Metformin Therapy in Diabetes: The Role of Cardioprotection. Curr Atheroscler Rep 15, 314 (2013). https://doi.org/10.1007/s11883-013-0314-z

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