
A drug currently being tested to treat anemia may hold new hope for people with diabetes who suffer heart attacks, according to groundbreaking research from the University of Oxford.
Scientists have discovered that molidustat, an oral medication now in phase III clinical trials for chronic kidney disease-related anemia, could help diabetic hearts recover more effectively after a heart attack and reduce the risk of heart failure.
The study, published in the journal Diabetes and funded by the British Heart Foundation, highlights how molidustat may offer a solution to a long-standing challenge in cardiovascular medicine: the diabetic heart’s poor ability to survive and heal after being deprived of oxygen during a heart attack.
During a heart attack, blood flow—and therefore oxygen—to parts of the heart is restricted or cut off entirely. This oxygen shortage, known as hypoxia, causes damage or death to heart cells. In people with diabetes, heart cells are more vulnerable to this damage and tend to die more quickly, making recovery harder and increasing the chance of developing heart failure.
The Oxford researchers found that molidustat helps protect these vulnerable heart cells by boosting levels of a protein called HIF-1 (Hypoxia-Inducible Factor 1). This protein plays a crucial role in helping cells adapt to low oxygen conditions by turning on genes that promote survival and healing.
However, in people with diabetes, HIF-1 levels in heart cells are unusually low, which may be one reason their hearts struggle to recover after injury.
In the study, the team first examined how human heart cells reacted to low oxygen levels. Cells with insulin resistance—a hallmark of type 2 diabetes—produced significantly less HIF-1 than normal cells. But when these insulin-resistant cells were treated with molidustat, HIF-1 levels increased, as did activity in the genes responsible for helping the cells survive and adapt.
The researchers then tested the drug in rats. They exposed hearts from both diabetic and non-diabetic rats to low oxygen levels. As expected, the diabetic hearts performed worse. But when treated with molidustat, the diabetic hearts showed a dramatic improvement, recovering heart function to levels similar to those without diabetes.
Molidustat also helped with angiogenesis—the process of forming new blood vessels. This is vital for healing after a heart attack, as new vessels help restore blood flow to damaged areas. Angiogenesis tends to be weaker in people with diabetes, contributing to poorer outcomes.
However, rats with diabetes that were given molidustat showed increased levels of signals that promote new vessel growth, suggesting better long-term recovery potential.
Dr. Lisa Heather, who led the study, emphasized the importance of these results:
“Even with the best diabetes care, people with type 2 diabetes still face a higher risk of heart disease. Right now, there are no treatments specifically designed to help the diabetic heart recover after a heart attack. Our findings suggest molidustat could fill this gap and improve survival and quality of life.”
Professor Metin Avkiran of the British Heart Foundation added:
“Heart disease is the leading cause of death for people with diabetes. These early results are promising and show that drugs that stabilize HIF—like molidustat—could offer a new way to protect the heart after a heart attack.”
Although these findings are still in the early stages and more research is needed, they point to an exciting new possibility: using an existing drug in a new way to protect millions of people with diabetes from heart failure. If future studies confirm these results in humans, molidustat could become an important tool in treating one of the most serious complications of diabetes.
If you care about diabetes, please read studies that pomace olive oil could help lower blood cholesterol, and honey could help control blood sugar.
For more information about health, please see recent studies that blueberries strongly benefit people with metabolic syndrome, and results showing eggs in a plant-based diet may benefit people with type 2 diabetes.
The research findings can be found in Diabetes.
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