title: The cardioprotective effects of metformin.
abstract: OBJECTIVE
  In patients with type 2 diabetes mellitus, treatment with metformin is associated with a lower cardiovascular morbidity and mortality, compared with alternative glucose-lowering drugs. It has been suggested that metformin might exert direct protective effects on the heart.
  
  
  RESULTS
  This review appraises recent experimental animal studies on the effect of metformin on myocardial ischaemia-reperfusion injury and remodeling. In murine models of myocardial infarction, the administration of metformin potently limits infarct size. Activation of adenosine monophosphate-activated protein kinase, increased formation of adenosine, and the prevention of opening of the mitochondrial permeability transition pore at reperfusion all contribute to this cardioprotective effect. In addition, metformin therapy attenuates postinfarction cardiac remodeling. There is evidence that activation of adenosine monophosphate-activated protein kinase and endothelial nitric oxide synthase, and a reduced collagen expression are crucial for this effect.
  
  
  CONCLUSIONS
  The finding that metformin limits myocardial infarct size and remodeling in animal models of myocardial infarction suggests that patients suffering from myocardial ischaemia could benefit from treatment with metformin, even when these patients do not have diabetes. Currently, several clinical trials are being performed to test this hypothesis.
authors: Department of Pharmacology-Toxicology, Radboud University Nijmegen Medical Centre, Nijmegen, the Netherlands.
authors: Saloua
authors: S
authors: El Messaoudi
authors: Gerard A
authors: GA
authors: Rongen
authors: Rudolf A
authors: RA
authors: de Boer
authors: Niels P
authors: NP
authors: Riksen
mesh_terms: D000818:Animals; D002316:Cardiotonic Agents / Q000494:pharmacology / Q000627:therapeutic use*; D002986:Clinical Trials as Topic; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000188:drug therapy; D058065:Diabetic Cardiomyopathies / Q000188:drug therapy / Q000209:etiology / Q000517:prevention & control*; D006333:Heart Failure / Q000517:prevention & control; D006801:Humans; D008687:Metformin / Q000494:pharmacology / Q000627:therapeutic use*; D017202:Myocardial Ischemia / Q000188:drug therapy / Q000209:etiology; D015428:Myocardial Reperfusion Injury / Q000517:prevention & control; D020257:Ventricular Remodeling / Q000187:drug effects
chemical_list: D002316:Cardiotonic Agents; D008687:Metformin