Diabetes Drug Helped Slow Heart Disease

Doctors say they have shown for the first time that a diabetes drug can prevent the progression of coronary heart disease.
The Cleveland Clinic-led study involved 543 patients with Type 2 diabetes. It compared two drugs, Actos and Amaryl, which act in opposite ways: Actos is part of a newer class of drugs that reduce insulin resistance, while Amaryl is an older drug that increases insulin production.
Using intravascular ultrasound, researchers found that after 18 months, Actos was significantly better at reducing progression of plaque buildup in arteries of the heart.

"Seventy-five percent of diabetics will die of a cardiovascular-related cause," study leader Dr. Steven Nissen, the Clinic chief of cardiovascular medicine, said in an interview Monday. "If you can find a therapy that reduces progression of heart disease and atheroslcerosis, that will potentially have a very big impact."

The study is published in Wednesday's Journal of the American Medical Association. Results were released Monday, after presentation at the American College of Cardiology scientific conference in Chicago.
Previous studies have shown that Actos may lower risk of heart attack and stroke. The drug also carries increased risk of heart failure and bone fractures.
The question of whether blood-sugar control can reduce heart disease has been controversial, an editorial that accompanied the study said. Part of a federally sponsored trial was stopped earlier this year, after an unexpected number of patients died while undergoing aggressive therapy to lower blood sugar.
Warnings have also been raised about the diabetes drug Avandia -- a chemical relative of Actos -- after Nissen last year tied Avandia to increased risk of heart attack.
Doctors said the new results suggest that lowering blood sugar may not be as important for heart health as the choice of drug.
"There's clearly more to the story than just getting the sugars down," said Dr. Emil Hayek, medical director of Akron General Medical Center's Heart and Vascular Center. "I think it should change clinical practice. There's clearly a benefit to using some of the more novel ways to treat diabetes."
Hayek added that the results suggest Actos may prevent heart attacks and strokes, but "that's a much more difficult question to answer."
Takeda Pharmaceuticals North America Inc., which makes Actos, paid for the study.