SEATTLE — Treatment with metformin over one year
prevented plaque progression in a population of HIV-infected individuals with
metabolic syndrome.
“Recent data suggest increased cardiovascular
events among patients with HIV, with a 75% increased rate of myocardial
infarction compared with non-HIV patients,” Kathleen Fitch, NP, of
Massachusetts General Hospital, said during a press conference here.
“Studies have shown that a doubling of plaque is
related to a 26% increase in cardiovascular disease events. Cardiac artery
calcification is increased in
HIV patients, but the effects of lifestyle modifications and
metformin have not been evaluated in the HIV population.”
For this reason, Fitch and colleagues conducted a
12-month randomized, placebo-controlled trial to assess lifestyle modification
and metformin use, alone and together, among HIV-positive individuals with
metabolic syndrome. Primary outcome measure was change in coronary artery
calcification score and calcified plaque volume measured by a 64-slice CT
scanner. The study included 50 participants, whose fasting lipids, insulin and
cardiorespiratory fitness were assessed.
The researchers found that participants who received
metformin had significantly less progression of coronary artery calcification
during the 12 month period: -1 ± 2 vs. 33 ± 17 (P=.004).
They also had less progression in calcified plaque volume: -0.4 ± 1.9
vs. 27.6 ± 13.8 mm3 (P=.008).
Participants who were randomly assigned to lifestyle
modifications showed improvement in HDL and cardiorespiratory fitness, but
lifestyle modifications showed no significant effect on coronary artery
calcification.
“Our results demonstrate that metformin had an
effect on plaque progression in patients with HIV and
metabolic syndrome,” Fitch said. “Importantly,
these data also highlight a 50% rate of plaque progression in the non-treatment
group, suggesting a very high rate in the natural history of plaque progression
in these patients. In contrast, studies done in the general population
regarding plaque progression show that plaque progresses at about half of this
rate.”
For more information:
- Fitch K. #119. Presented at: 19th Conference on
Retroviruses and Opportunistic Infections; March 5-8, 2012; Seattle.
Disclosure: Dr. Fitch reports no relevant
financial disclosures.