PMID- 20206893
OWN - NLM
STAT- MEDLINE
DCOM- 20100607
LR  - 20220414
IS  - 1532-8414 (Electronic)
IS  - 1071-9164 (Print)
IS  - 1071-9164 (Linking)
VI  - 16
IP  - 3
DP  - 2010 Mar
TI  - Metformin therapy and outcomes in patients with advanced systolic heart failure 
      and diabetes.
PG  - 200-6
LID - 10.1016/j.cardfail.2009.10.022 [doi]
AB  - 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.
CI  - Copyright (c) 2010 Elsevier Inc. All rights reserved.
FAU - Shah, Digish D
AU  - Shah DD
AD  - Cedars Sinai Medical Center, Los Angeles, CA, USA.
FAU - Fonarow, Gregg C
AU  - Fonarow GC
FAU - Horwich, Tamara B
AU  - Horwich TB
LA  - eng
GR  - K23 HL085097/HL/NHLBI NIH HHS/United States
GR  - K23 HL085097-01A1/HL/NHLBI NIH HHS/United States
GR  - 1K23 HL 085097/HL/NHLBI NIH HHS/United States
PT  - Comparative Study
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
PT  - Research Support, Non-U.S. Gov't
DEP - 20091114
PL  - United States
TA  - J Card Fail
JT  - Journal of cardiac failure
JID - 9442138
RN  - 0 (Hypoglycemic Agents)
RN  - 9100L32L2N (Metformin)
SB  - IM
CIN - J Card Fail. 2010 Mar;16(3):207-10. PMID: 20206894
MH  - Aged
MH  - Cohort Studies
MH  - Confidence Intervals
MH  - Diabetes Mellitus, Type 2/diagnosis/*drug therapy/*epidemiology
MH  - Female
MH  - Heart Failure, Systolic/diagnosis/*epidemiology
MH  - Heart Function Tests
MH  - Humans
MH  - Hypoglycemic Agents/*administration & dosage/adverse effects
MH  - Male
MH  - Metformin/*administration & dosage/adverse effects
MH  - Middle Aged
MH  - Multivariate Analysis
MH  - Probability
MH  - Prognosis
MH  - Proportional Hazards Models
MH  - Retrospective Studies
MH  - Severity of Illness Index
MH  - Survival Analysis
MH  - Treatment Outcome
PMC - PMC2855621
MID - NIHMS185795
EDAT- 2010/03/09 06:00
MHDA- 2010/06/09 06:00
PMCR- 2010/04/16
CRDT- 2010/03/09 06:00
PHST- 2009/05/06 00:00 [received]
PHST- 2009/10/07 00:00 [revised]
PHST- 2009/10/15 00:00 [accepted]
PHST- 2010/03/09 06:00 [entrez]
PHST- 2010/03/09 06:00 [pubmed]
PHST- 2010/06/09 06:00 [medline]
PHST- 2010/04/16 00:00 [pmc-release]
AID - S1071-9164(09)01132-4 [pii]
AID - 10.1016/j.cardfail.2009.10.022 [doi]
PST - ppublish
SO  - J Card Fail. 2010 Mar;16(3):200-6. doi: 10.1016/j.cardfail.2009.10.022. Epub 2009 
      Nov 14.