Diabetes Drug Shows Promise Against Heart Attacks
From the annual American Heart Association meeting in Chicago: Part two in a series of web-exclusive articles
A clinical trial described on Monday at the American Heart Association's annual science meeting suggests that a drug already taken by many diabetics for insulin control may also stave off a heart attack.
For someone with type 2 diabetes, the risk of a heart attack is considered as high as in someone who has already had one. Even if blood sugar and cholesterol are well controlled, there's still additional risk. Diabetes promotes stiffening and thickening of artery lining, a process that could lead to a completely blocked vessel. Or a fatty plaque that develops inside the lining could rupture, creating an instant clot that could cut off blood flow, causing a killer heart attack or stroke.
In the 18-month trial, conducted at Chicago-area hospitals on 462 adults with diabetes, the intima, or inner lining of the carotid arteries of the neck, virtually stopped thickening in patients who were given pioglitazone, sold by Takeda Pharmaceuticals as Actos.
Thickening in the carotid arteries usually means the same thing is happening in the coronary arteries. But unlike the tiny coronary arteries, buried beneath the ribs and the protective sac around the heart, the carotid arteries are large and close to the surface. Their health is easy to check with an ultrasound test called an echocardiogram.
Pioglitazone helps diabetics utilize insulin as efficiently as possible, which is important because the insulin-producing organ, the pancreas, usually doesn't manufacture as much as it should.
In a second group of patients who got glimepiride, sold as a generic drug and marketed by Aventis as Amaryl, the thickening continued. Glimepiride stimulates the pancreas to produce more insulin.
Lead researcher Theodore Mazzone, chief of endocrinology, diabetes, and metabolism at the University of Illinois–Chicago, was cautiously optimistic about the findings. Extending them to doctors' offices "would not necessarily be wise," he says, as lack of thickening of the lining of one artery doesn't automatically signify fewer heart attacks for diabetics. But he noted that the drug's effect held true for all of the patients in the study–"elderly or not, male or female, obese or not, taking statins or not"–which is a good sign.
Troglitazone, a drug in the same class as pioglitazone and sold as Rezulin, was withdrawn in March of 2000 after reports of liver failure. Pioglitazone has been on the U.S. market since 1999 and has generated no alarms.
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