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J Am Coll Cardiol, 2006; 48:956-963, doi:10.1016/j.jacc.2006.04.088 (Published online 14 August 2006).
© 2006 by the American College of Cardiology Foundation
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Effects of Metformin on Microvascular Function and Exercise Tolerance in Women With Angina and Normal Coronary Arteries

A Randomized, Double-Blind, Placebo-Controlled Study

Sachin Jadhav, MD{dagger}, William Ferrell, PhD{dagger}, Ian A. Greer, MD{ddagger}, John R. Petrie, MD, PhD§, Stuart M. Cobbe, MD{dagger} and Naveed Sattar, MD, PhD*,*

* BHF Glasgow Cardiovascular Research Centre, University of Glasgow, Glasgow Royal Infirmary, Glasgow, Scotland
{dagger} Division of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow Royal Infirmary, Glasgow, Scotland
{ddagger} Division of Developmental Medicine, University of Glasgow, Glasgow Royal Infirmary, Glasgow, Scotland
§ Division of Medicine and Therapeutics, Ninewells Hospital and Medical School, Dundee, Scotland.


Figure 1
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  		Figure 1 The CONSORT (Consolidated Standards of Reporting Trial) diagram describing outcomes of all women within the study. 1Gastrointestinal side effects. 2There was 1 patient admitted with chest pain, 1 patient with gastrointestinal side effects, and 2 patients with nonspecific symptoms. ETT = exercise tolerance test.

 

Figure 2
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  		Figure 2 (A) Baseline and on-treatment (8 weeks) microvascular responses to acetylcholine (ACh) in the 16 women randomized to metformin (p = 0.0003, 2-way repeated measures analysis of variance [ANOVA]). (B) Baseline and on-treatment (8 weeks) microvascular responses to ACh in the 17 women randomized to placebo (p = 0.50, 2-way repeated measures ANOVA). (C) Baseline and on-treatment (8 weeks) microvascular responses to sodium nitroprusside (SNP) in the 16 women randomized to metformin (p = 0.46, 2-way repeated measures ANOVA). (D) Baseline and on-treatment (8 weeks) microvascular responses to SNP in the 17 women randomized to placebo (p = 0.95, 2-way repeated measures ANOVA).

 

Figure 3
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  		Figure 3 (A) Change over 8 weeks in microvascular responses to acetylcholine (ACh) in metformin and placebo groups (p < 0.0001, 2-way repeated measures analysis of variance [ANOVA]). (B) Change over 8 weeks in microvascular responses to sodium nitroprusside (SNP) in metformin and placebo groups (p = 0.55, 2-way repeated measures ANOVA).

 

Figure 4
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  		Figure 4 (A) Mean maximal ST-segment depression during exercise tolerance test (ETT) (mm) at baseline and on treatment (8 weeks) in the 33 women randomized to placebo (n = 17) or metformin (n = 16). (B) Median chest pain incidence before randomization and on treatment in the 33 women randomized to placebo (n = 17) or metformin (n = 16).

 




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