Document Detail


Metformin use and mortality in ambulatory patients with diabetes and heart failure.
MedLine Citation:
PMID:  20952583     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
David Aguilar; Wenyaw Chan; Biykem Bozkurt; Kumudha Ramasubbu; Anita Deswal
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Publication Detail:
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:
Title:  Circulation. Heart failure     Volume:  4     ISSN:  1941-3297     ISO Abbreviation:  Circ Heart Fail     Publication Date:  2011 Jan 
Date Detail:
Created Date:  2011-01-19     Completed Date:  2011-02-17     Revised Date:  2012-01-04    
Medline Journal Info:
Nlm Unique ID:  101479941     Medline TA:  Circ Heart Fail     Country:  United States    
Other Details:
Languages:  eng     Pagination:  53-8     Citation Subset:  IM    
Affiliation:
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
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MeSH Terms
Descriptor/Qualifier:
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:
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:
0/Hypoglycemic Agents; 657-24-9/Metformin
Comments/Corrections
Comment In:
Expert Rev Cardiovasc Ther. 2011 Feb;9(2):147-50   [PMID:  21453211 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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