Metformin Therapy and Outcomes in Patients With Advanced Systolic Heart Failure and Diabetes
Open accessAbstract
Background Although 25% to 44% of patients with heart failure (HF) have diabetes mellitus (DM), the optimal treatment regimen for HF patients with DM is uncertain. We investigated the association between metformin therapy and outcomes in a cohort of advanced, systolic HF patients with DM.Methods and results Patients with DM and advanced, systolic HF (n = 401) were followed at a single university HF center between 1994 and 2008. The cohort was divided into 2 groups based on the presence or absence of metformin therapy. The cohort had a mean age of 56 +/- 11 years, left ventricular ejection fraction (LVEF) of 24 +/- 7%, with 42% being New York Heart Association (NYHA) III and 45% NYHA IV. Twenty-five percent (n = 99) were treated with metformin therapy. The groups treated and not treated with metformin were similar in terms of age, sex, baseline LVEF, medical history, and baseline glycosylated hemoglobin. Metformin-treated patients had a higher body mass index, lower creatinine, and were less often on insulin. One-year survival in metformin-treated and non-metformin-treated patients was 91% and 76%, respectively (RR = 0.37, CI 0.18-0.76, P = .007). After multivariate adjustment for demographics, cardiac function, renal function, and HF medications, metformin therapy was associated with a nonsignificant trend for improved survival.Conclusion In patients with DM and advanced, systolic HF who are closely monitored, metformin therapy appears to be safe. Prospective studies are needed to determine whether metformin can improve HF outcome.
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In patients with diabetes mellitus and advanced systolic heart failure, one-year survival in metformin-treated and non-metformin-treated patients was 91% and 76%, respectively (p=0.007).
“One-year survival in metformin-treated and non-metformin-treated patients was 91% and 76%, respectively (p = 0.007).”
From Metformin: An Old But Still the Best Treatment for Type 2 Diabetes (2013) · cites this paper as [85]
After multivariate adjustment, metformin therapy was associated with a non-significant trend of improved survival in patients with diabetes mellitus and advanced systolic heart failure.
“After a multivariate adjustment for demographics, cardiac function, renal function, and HF medications, metformin therapy was associated with a non-significant trend of improved survival [85].”
From Metformin: An Old But Still the Best Treatment for Type 2 Diabetes (2013) · cites this paper as [85]
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Self-citationMetformin Therapy in Heart Failure Patients with Pre-Diabetes and Diabetes
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Influence of Metformin Discontinuation on Readmission Rate in Patients with Acute Heart Failure
Wong, C., Junqueira, E., Poldiak, N. P., Crossley, N., & Jenkins, S. H. P. (2024) · Journal of Community Hospital Internal Medicine Perspectives · doi:10.55729/2000-9666.1366
- Authors
- Shah, D. D., Fonarow, G. C., & Horwich, T. B.
- Affiliations
- Cedars-Sinai Medical Center (US)
- University of California, Los Angeles (US)
- Corresponding author
- Horwich, Tamara B.
- Venue
- Journal of Cardiac Failure
- Publisher
- Elsevier BV
- Published
- 2010-03
- Volume
- 16
- Issue
- 3
- Pages
- 200-206
- ISSN
- 1071-9164 (ISSN-L)
- PMC
- PMC2855621
- OpenAlex
- W2073910667
- Cited by
- 100
- References
- 37
- Citations by year
- 2024: 5 · 2023: 6 · 2022: 6 · 2021: 5 · 2020: 11 · 2019: 11 · 2018: 7 · 2017: 10 · 2016: 4 · 2015: 2 · 2014: 2 · 2013: 8 · 2012: 11
- FWCI
- 4.75
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Licence
- Locations
- Journal of Cardiac Failure (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health (5k23hl085097-04)
- National Heart, Lung, and Blood Institute (1K23HL085097, K23 HL085097)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Failure Treatment and Management
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Function and Risk Factors
- Keywords
- metformin, heart failure with reduced ejection fraction, diabetes mellitus, advanced heart failure, survival, left ventricular ejection fraction, HbA1c, renal function, insulin use, drug safety
- MeSH terms
- Aged, Diabetes Mellitus, Type 2, Female, Heart Function Tests, Humans, Hypoglycemic Agents, Male, Metformin, Middle Aged, Probability, Prognosis, Retrospective Studies, Severity of Illness Index, Cohort Studies, Multivariate Analysis, Confidence Intervals, Proportional Hazards Models, Survival Analysis, Treatment Outcome, Heart Failure, Systolic
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