Metformin in the Treatment of Coronary Heart Disease

Background: Atherosclerosis and coronary heart disease (CHD) may be the main causes of aging and death in human being. Methods: All patients with Sickle Cell Diseases (SCD) were included. Results: We studied 222 males and 212 females with similar mean ages (30.8 vs 30.3 years, p>0.05, respectively). Smoking (23.8% vs 6.1%, p<0.001), alcohol (4.9% vs 0.4%, p<0.001), transfused red blood cells (RBC) in their lives (48.1 vs 28.5 units, p=0.000), disseminated teeth losses (5.4% vs 1.4%, p<0.001), ileus (7.2% vs 1.4%, p<0.001), CHD (18.0% vs 13.2%, p<0.05), cirrhosis (8.1% vs 1.8%, p<0.001), chronic obstructive pulmonary disease (25.2% vs 7.0%, p<0.001), leg ulcers (19.8% vs 7.0%, p<0.001), digital clubbing (14.8% vs 6.6%, p<0.001), chronic renal disease (9.9% vs 6.1%, p<0.05), and stroke (12.1% vs 7.5%, p<0.05) were higher in males. Conclusion: As a prototype of systemic atherosclerosis, hardened RBC-induced capillary endothelial damage initiating at birth terminates with end-organ failures in much earlier ages in the SCD. Excess fat tissue may be much more important than smoking and alcohol for the development of atherosclerosis all over the world, and CHD may be the terminal cause of death in everybody at the moment. The efficacy of metformin in loss of appetite is well known in the literature. Since metformin is a safe, cheap, orally used, and effective drug for excess weight, it should be advised in CHD even in normal weight since there are nearly 20 kg of excess fat tissue even between the upper and lower borders of normal weight in adults.