| Title |
Cardioprotection by Metformin: Beneficial Effects Beyond Glucose Reduction
|
|---|---|
| Published in |
American Journal of Cardiovascular Drugs, February 2018
|
| DOI | 10.1007/s40256-018-0266-3 |
| Pubmed ID | |
| Authors |
Leon Varjabedian, Mohammad Bourji, Leili Pourafkari, Nader D. Nader |
| Abstract |
Metformin is a biguanide that is widely used as an insulin-sparing agent to treat diabetes. When compared with the general population, diabetics are twice as likely to die from fatal myocardial infarction and congestive heart failure (CHF). There has been a significant concern regarding the use of metformin in patients with CHF because of their higher tendency to develop lactic acidosis. However, large epidemiological trials have reported better cardiovascular prognosis with metformin compared to other glucose-lowering agents among diabetics. Additionally, metformin has reduced the risk of reinfarction and all-cause mortality in patients with coronary artery disease and CHF, respectively. The protection against cardiovascular diseases appears to be independent of the anti-hyperglycemic effects of metformin. These effects are mediated through an increase in 5' adenosine monophosphate-activated protein kinase (AMPK) phosphorylation and by increased phosphorylation of endothelial nitric oxide synthase (eNOS) in cardiomyocytes with an increased production of nitric oxide (NO). Metformin preconditions the heart against ischemia-reperfusion injury and may improve myocardial remodeling after an ischemic insult. The preponderance of evidence currently suggests that metformin is safe in patients with CHF, prompting the Food and Drug Administration to remove CHF as a contraindication from the package insert of all generic metformin preparations. In this narrative, along with a limited meta-analysis of available studies, we have reviewed the pleiotropic (non-glucose-lowering) effects of metformin that potentially contribute to its cardioprotective properties. Additionally, we have reviewed issues surrounding the safety of metformin in patients with cardiac diseases. |
X Demographics
The data shown below were collected from the profiles of 42 X users who shared this research output. Click here to find out more about how the information was compiled.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Spain | 21 | 50% |
| Mexico | 2 | 5% |
| Unknown | 19 | 45% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Members of the public | 28 | 67% |
| Practitioners (doctors, other healthcare professionals) | 9 | 21% |
| Scientists | 5 | 12% |
Mendeley readers
The data shown below were compiled from readership statistics for 72 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 72 | 100% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Student > Ph. D. Student | 14 | 19% |
| Student > Bachelor | 7 | 10% |
| Student > Doctoral Student | 7 | 10% |
| Researcher | 6 | 8% |
| Student > Master | 5 | 7% |
| Other | 15 | 21% |
| Unknown | 18 | 25% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 25 | 35% |
| Agricultural and Biological Sciences | 4 | 6% |
| Biochemistry, Genetics and Molecular Biology | 4 | 6% |
| Pharmacology, Toxicology and Pharmaceutical Science | 3 | 4% |
| Immunology and Microbiology | 2 | 3% |
| Other | 13 | 18% |
| Unknown | 21 | 29% |
Attention Score in Context
This research output has an Altmetric Attention Score of 24. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 20 July 2022.
All research outputs
#1,606,855
of 25,732,188 outputs
Outputs from American Journal of Cardiovascular Drugs
#20
of 476 outputs
Outputs of similar age
#34,267
of 345,139 outputs
Outputs of similar age from American Journal of Cardiovascular Drugs
#1
of 8 outputs
Altmetric has tracked 25,732,188 research outputs across all sources so far. Compared to these this one has done particularly well and is in the 93rd percentile: it's in the top 10% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 476 research outputs from this source. They typically receive a little more attention than average, with a mean Attention Score of 6.7. This one has done particularly well, scoring higher than 96% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 345,139 tracked outputs that were published within six weeks on either side of this one in any source. This one has done particularly well, scoring higher than 90% of its contemporaries.
We're also able to compare this research output to 8 others from the same source and published within six weeks on either side of this one. This one has scored higher than all of them