Author + information
- Türkan Seda Tan Kürklü,
- Aydan Ongun,
- Haci Ali Kürklü,
- Çiğdem Koca,
- Ali Timuçin Altın,
- Çağdaş Özdöl and
- Çetin Erol
Metformin is a biguanid class, oral antidiabetic drug used in patients with type 2 Diabetes Mellitus (DM). By increasing insulin sensitivity in tissues, metformin mitigates insulin resistance which is the most important factor causing endothelial dysfunction. It is known that metformin limits the infarct size after myocardial infarction, reduces aneurysm development and remodeling in the ventricle even in the prediabetic period. The current study was undertaken to assess the effects of metformin therapy on coroner collateral development in type 2 diabetes patients.
Study population consisted of 152 consecutive patients who have undergone coronary angiography and who had at least one major coronary artery stenosis of ≥95%. Coronary collateral circulations were graded from 0 to 3 according to the Cohen-Rentrop method. And, collateral grading was classified as poor collateral development when the collateral grade was 0 to 1, and as good collateral development when the grade was 2 to 3. The effect of metformin therapy on the coronary collateral growth was analyzed. Furthermore, patients taking metformin were divided into two subgroups as high-dose (>1000 mg) and low-dose (≤1000 mg) patients. So, the effect of the dosage of the drug on coronary collateral development was also assessed.
The mean age of the study population was 65,24±9,71 years. 89 of the cases (58,55%) were males, and 63 of them (41,45%) were females. No statistical difference was determined between the groups’ demographic and laboratory characteristics. Metformin therapy had no effect on coronary collateral development according to the Rentrop classification (p=0,657). Correspondingly, good and poor coronary collateral formations of the groups were similar (p=0,837). 31 patients (63,30%) in the high-dose metformin group were identified as having good collaterals, whereas only 7 cases (31,80%) of the low-dose group had good collaterals. In conclusion, patients who have used high-dose metformin had significantly better coronary collaterals (p=0,014).
In our study, we have found that metformin therapy had no effect on the development of coronary collaterals in the patients with type 2 DM. In contrast, patients who were on high-dose metformin therapy had significantly better coronary collateral development. To the best of our knowledge, this is the first study evaluating the effects of metformin on coronary collateral formation. Finally, larger, prospective studies are necessary to find out the effects of metformin treatment on coronary collateral development.
|Good collaterals, (%)||7 (31,8)||31 (63,3)||0,014|
|Poor collaterals, (%)||15 (68,2)||18 (36,7)|