| Effect of Metformin on mortality in patients with heart failure and type 2 diabetes mellitus. | |
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MedLine Citation:
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PMID: 20854965 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Type 2 diabetes mellitus (DM) plus chronic heart failure (CHF) is a common but lethal combination and therapeutic options are limited. Metformin is perceived as being relatively contraindicated in this context, although mounting evidence indicates that it may be beneficial. This study was carried out to investigate the use of metformin therapy for treating patients with DM and CHF in a large population-based cohort study. The Health Informatics Centre-dispensed prescribing database for the population of Tayside, Scotland (population ∼400,000) was linked to the Diabetes Audit and Research in Tayside Scotland (DARTS) information system. Patients with DM and incident CHF from 1994 to 2003 receiving oral hypoglycemic agents but not insulin were identified. Cox regression was used to assess differences in all-cause mortality rates between patients prescribed metformin and patients prescribed sulfonylureas with adjustment for co-morbidities and other therapies. Four hundred twenty-two study subjects (mean ± SD 75.4 ± 0.5 years of age, 46.2% women) were identified: metformin monotherapy (n = 68, mean age 75.5 ± 1.1 years, 48.5% women), sulfonylurea monotherapy (n = 217, mean age 76.7 ± 0.7 years, 45.2% women), and combination (n = 137, mean age, 73.4 ± 0.7 years, 46.7% women). Fewer deaths occurred in metformin users, alone or in combination with sulfonylureas, compared to the sulfonylurea monotherapy cohort at 1 year (0.59, 95% confidence interval 0.36 to 0.96) and over long-term follow up (0.67, 95% confidence interval 0.51 to 0.88). In conclusion, this large observational data suggest that metformin may be beneficial in patients with CHF and DM. These findings need to be verified by a prospective clinical trial. |
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Authors:
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Josie M M Evans; Alex S F Doney; Matlooba A AlZadjali; Simon A Ogston; John R Petrie; Andrew D Morris; Allan D Struthers; Aaron K F Wong; Chim C Lang |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: The American journal of cardiology Volume: 106 ISSN: 1879-1913 ISO Abbreviation: Am. J. Cardiol. Publication Date: 2010 Oct |
Date Detail:
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Created Date: 2010-09-21 Completed Date: 2010-10-26 Revised Date: 2011-10-19 |
Medline Journal Info:
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Nlm Unique ID: 0207277 Medline TA: Am J Cardiol Country: United States |
Other Details:
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Languages: eng Pagination: 1006-10 Citation Subset: AIM; IM |
Copyright Information:
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Copyright © 2010 Elsevier Inc. All rights reserved. |
Affiliation:
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Department of Nursing and Midwifery, University of Stirling, Stirling, United Kingdom. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Aged Diabetes Complications / drug therapy, mortality* Diabetes Mellitus, Type 2 / drug therapy* Female Heart Failure / drug therapy, mortality* Humans Hypoglycemic Agents / therapeutic use* Male Metformin / therapeutic use* Treatment Outcome |
| Grant Support | |
ID/Acronym/Agency:
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PG/06/143/21897//British Heart Foundation |
| Chemical | |
Reg. No./Substance:
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0/Hypoglycemic Agents; 657-24-9/Metformin |
| Comments/Corrections | |
Comment In:
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Rev Clin Esp. 2011 Sep;211(8):427-8 |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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