| Metformin use and mortality in ambulatory patients with diabetes and heart failure. | |
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MedLine Citation:
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PMID: 20952583 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Despite the common coexistence of diabetes and heart failure (HF), the optimal medial treatment of diabetes in HF patients has not been well studied. We sought to compare the association between metformin use and clinical outcomes in a cohort of ambulatory patients with diabetes and established HF. METHODS AND RESULTS: Using propensity score-matched samples, we examined the association between metformin use and the risk of death or risk of hospitalization in a national cohort of 6185 patients with HF and diabetes treated in ambulatory clinics at Veteran Affairs medical centers. In this cohort, 1561 (25.2%) patients were treated with metformin. At 2 years of follow-up, death occurred in 246 (15.8%) patients receiving metformin and in 1177 (25.5%) patients not receiving metformin (P<0.001). In the propensity score-matched analysis (n=2874), death occurred in 232 (16.1%) patients receiving metformin compared with 285 (19.8%) patients not receiving metformin (hazard ratio, 0.76; 95% confidence interval, 0.63 to 0.92; P<0.01). In propensity score-matched analyses, HF hospitalization or total hospitalization rates were not significantly different between individuals treated with metformin compared with those not treated with metformin (hazard ratio, 0.93; 95% confidence interval, 0.74 to 1.18; and hazard ratio, 0.94; 95% confidence interval, 0.83 to 1.07, respectively). CONCLUSIONS: Metformin therapy was associated with lower rates of mortality in ambulatory patients with diabetes and HF. Future prospective studies are necessary to define the optimal therapy for diabetic patients with HF. |
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Authors:
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David Aguilar; Wenyaw Chan; Biykem Bozkurt; Kumudha Ramasubbu; Anita Deswal |
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Publication Detail:
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Type: Journal Article; Multicenter Study; Research Support, N.I.H., Extramural; Research Support, U.S. Gov't, Non-P.H.S. Date: 2010-10-15 |
Journal Detail:
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Title: Circulation. Heart failure Volume: 4 ISSN: 1941-3297 ISO Abbreviation: Circ Heart Fail Publication Date: 2011 Jan |
Date Detail:
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Created Date: 2011-01-19 Completed Date: 2011-02-17 Revised Date: 2012-01-04 |
Medline Journal Info:
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Nlm Unique ID: 101479941 Medline TA: Circ Heart Fail Country: United States |
Other Details:
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Languages: eng Pagination: 53-8 Citation Subset: IM |
Affiliation:
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Winters Center for Heart Failure Research and Section of Cardiology, Department of Medicine, Baylor College of Medicine, 1709 Dryden Street, Houston, TX 77030, USA. daguilar@bcm.edu |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Aged Cohort Studies Comorbidity Diabetes Mellitus / drug therapy*, epidemiology, mortality* Female Follow-Up Studies Heart Failure / drug therapy*, epidemiology, mortality* Humans Hypoglycemic Agents / therapeutic use* Male Metformin / therapeutic use* Middle Aged Retrospective Studies Survival Rate Treatment Outcome |
| Grant Support | |
ID/Acronym/Agency:
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5K01-HL092585-02/HL/NHLBI NIH HHS; K01 HL092585-03/HL/NHLBI NIH HHS; K01 HL092585-04/HL/NHLBI NIH HHS |
| Chemical | |
Reg. No./Substance:
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0/Hypoglycemic Agents; 657-24-9/Metformin |
| Comments/Corrections | |
Comment In:
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Expert Rev Cardiovasc Ther. 2011 Feb;9(2):147-50
[PMID:
21453211
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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