Certain Medications May Help Prevent Heart Attacks

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Insulin sensitizing pharmacotherapy for prevention of myocardial infarction in patients with diabetes mellitus, by W.H. Sauer and colleagues. Am J Cardiol 97:651–654, 2006.

What is the problem and what is known about it so far?

People with diabetes or a related pre-diabetes condition called insulin resistance are more likely to have a heart attack. Taking medication that improves the body's ability to handle insulin and glucose may reduce their chances of having a heart attack. But it's not known whether there are differences among the medications used to treat diabetes and insulin resistance.

Why did the researchers do this particular study?

The researchers wanted to compare the effects that medications (such as sulfonyureas, metformin, and thiazolidinedione) have on the chances that a person with diabetes or insulin resistance will have a heart attack.

Who was studied?

The study included almost 1,000 people with type 2 diabetes who had been treated for a heart attack during a 56-month period. They were compared to a second group of people with diabetes.

How was the study done?

Participants were interviewed about their medical history and medications that they took. Medications to treat diabetes and insulin resistance were categorized into sulfonyureas, metformin, or thiazolidinediones. The results were analyzed and compared to the group of patients who had not had a heart attack.

What did the researchers find?

Participants who took thiazolidinediones or metformin were about one-third less likely to have a heart attack as those who took sulfonyureas. Adding thiazolidinedione medication for somebody already taking sulfonyureas reduced their chance of having a heart attack, but adding metformin did not.

What were the limitations of the study?

The scientific methods used in the study were not very rigorous. A study with more strict guidelines might lead to different results. There could be other factors contributing to a reduced number of heart attacks that were not studied.

What are the implications of the study?

Medications used to treat diabetes and insulin resistance help lower a person's chance of having a heart attack. More research is needed to see if there are important differences between medications used to improve the body’s ability to handle insulin and glucose.

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