Metformin shown to substantially reduce major cardiovascular events in high-risk patients compared with glipizide

   Chinese researchers compared the long-term effects of glipizide and metformin on major cardiovascular (CV) events in high-risk patients with type 2 diabetes and a history of coronary artery disease (CAD). They found that treatment with metformin for three years substantially reduced major CV events, compared with glipizide, suggesting that treatment with this drug could be a good prevention strategy for CV disease in patients with type 2 diabetes.

    In a randomized trial, patients (N=304) with type II diabetes and CAD were randomly assigned to receive either glipizide plus metformin placebo or metformin plus glipizide placebo for three years. At a mean follow-up of three years, 91 participants had developed 103 primary end points -- time to the composite of recurrent CV events, including death from a CV cause, death from any cause, nonfatal myocardial infarction, nonfatal stroke, or arterial revascularization. Intent-to-treat analysis showed an adjusted hazard ratio of 0.54 (95% confidence interval, 0.30 to 0.90, P=0.026) for the composites of CV events among the patients who received metformin, compared with glipizide.