Metformin for PTDM Found to Lower CAD Risk

METFORMIN LOWERS the risk for coronary artery disease in kidney transplant patients with posttransplant diabetes mellitus (PTDM), researchers reported at the 2023 American Transplant Congress in San Diego. In a study that enrolled 1663 kidney transplant recipients without preexisting diabetes mellitus, PTDM developed in 634 (38.1%). Of these, 406 (64%) received treatment with metformin, Jae Lee, MD, of Asan Medical Center in Seoul, South Korea, and colleagues reported. Metformin use was significantly associated with a 76% lower risk for percutaneous coronary intervention

(PCI) compared with nonuse. Longterm use of metformin (1192 days [median value] or more) was significantly associated with a 78% lower risk for PCI and 55% lower risk for graft failure compared with fewer than 1192 days of use. In a subgroup given tacrolimus, metformin use was significantly associated with a 76% and 65% lower risk for PCI and graft failure, respectively. Metformin had a renoprotective effect in this subgroup, with users experiencing a significantly slower annual decline in estimated glomerular filtration rate compared with non-users (−0.053 vs −1.31 mL/min/1.73 m2). ■