Diabetes and heart disease often intersect. Emory cardiologist Aloke Finn and his colleagues recently had two papers in the Journal of the American College of Cardiology and in Atherosclerosis describing a possible interaction between the widely used diabetes drug metformin and drug-eluting stents, which are used to to treat coronary artery disease. Anwer Habib, MD is the first author of both papers.
The stent props the once-blocked artery open while the drugs in the stents are supposed to prevent the artery from becoming blocked again. The drugs — usually mTOR inhibitors such as http://www.magliettedacalcioit.com everolimus or the newer zotarolimus — slow down cell growth, but this cuts both ways. The drugs slow down the recovery of the lining of the blood vessel and this may contribute to blood clot formation after stent placement.
In cultured human cells and in rabbits with implanted stents, Finn and colleagues showed that metformin augmented the effect of mTOR inhibitors on regrowth of the blood vessel lining. (However — the authors acknowledge that their animal model was not diabetic or atherosclerotic.)
The findings could mean that people taking metformin would need to take medications to prevent blood clotting medications for a longer time after stent placement. The authors say that clinical studies following patients who receive drug-eluting stents should look at metformin’s effects on blood clotting events. A study examining drug eluting stents in diabetic patients is in the works at Emory.