PMID- 26453464
OWN - NLM
STAT- MEDLINE
DCOM- 20160707
LR  - 20240323
IS  - 1475-2840 (Electronic)
IS  - 1475-2840 (Linking)
VI  - 14
DP  - 2015 Oct 9
TI  - Effect of metformin monotherapy on cardiovascular diseases and mortality: a 
      retrospective cohort study on Chinese type 2 diabetes mellitus patients.
PG  - 137
LID - 10.1186/s12933-015-0304-2 [doi]
LID - 137
AB  - BACKGROUND: Many factors influence whether the first-line oral anti-diabetic 
      drug, metformin, should be initiated to a patient with type 2 diabetes mellitus 
      (T2DM) early in the course of management in addition to lifestyle modifications. 
      This study aims to evaluate the net effects of metformin monotherapy (MM) on the 
      all-cause mortality and cardiovascular disease (CVD) events. METHODS: A 
      retrospective 5-year follow-up cohort study was conducted on Chinese adult 
      patients with T2DM and without any CVD history under public primary care. Cox 
      proportional hazard regressions were performed to compare the risk of all-cause 
      mortality and CVD events (CHD, stroke, heart failure) between patients receiving 
      lifestyle modifications plus MM (MM groups) and those with lifestyle 
      modifications alone (control groups). RESULTS: 3400 pairs of matched patients 
      were compared. MM group had an incidence rate of 7.5 deaths and 11.3 CVD events 
      per 1000 person-years during a median follow-up period of 62.5 months whereas 
      control group had 11.1 deaths and 16.3 per 1000 person-years during a median 
      follow-up period of 43.5-44.5 months. MM group showed a 29.5 and 30-35% risk 
      reduction of all-cause mortality and CVD events (except heart failure) than 
      control group (P < 0.001). MM group was more prone to progress to chronic kidney 
      disease but this was not statistically significant. CONCLUSIONS: Type 2 diabetic 
      patients who were started on metformin monotherapy showed improvement in many of 
      the clinical parameters and a reduction in all-cause mortality and CVD events 
      than lifestyle modifications alone. If there is no contraindication and if 
      tolerated, diabetic patients should be prescribed with metformin early in the 
      course of the diabetic management to minimize their risk of having the 
      cardiovascular events and mortality in the long run.
FAU - Fung, Colman Siu Cheung
AU  - Fung CS
AD  - Department of Family Medicine and Primary Care, Li Ka Shing Faculty of Medicine, 
      The University of Hong Kong, 3/F Ap Lei Chau Clinic, 161 Main Street, Ap Lei 
      Chau, Hong Kong. cfsc@hku.hk.
FAU - Wan, Eric Yuk Fai
AU  - Wan EY
AD  - Department of Family Medicine and Primary Care, Li Ka Shing Faculty of Medicine, 
      The University of Hong Kong, 3/F Ap Lei Chau Clinic, 161 Main Street, Ap Lei 
      Chau, Hong Kong. yfwan@hku.hk.
FAU - Wong, Carlos King Ho
AU  - Wong CK
AD  - Department of Family Medicine and Primary Care, Li Ka Shing Faculty of Medicine, 
      The University of Hong Kong, 3/F Ap Lei Chau Clinic, 161 Main Street, Ap Lei 
      Chau, Hong Kong. carlosho@hku.hk.
FAU - Jiao, Fangfang
AU  - Jiao F
AD  - Department of Family Medicine and Primary Care, Li Ka Shing Faculty of Medicine, 
      The University of Hong Kong, 3/F Ap Lei Chau Clinic, 161 Main Street, Ap Lei 
      Chau, Hong Kong. francesj@connect.hku.hk.
FAU - Chan, Anca Ka Chun
AU  - Chan AK
AD  - Department of Family Medicine and Primary Care, Li Ka Shing Faculty of Medicine, 
      The University of Hong Kong, 3/F Ap Lei Chau Clinic, 161 Main Street, Ap Lei 
      Chau, Hong Kong. kcchanae@hku.hk.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20151009
PL  - England
TA  - Cardiovasc Diabetol
JT  - Cardiovascular diabetology
JID - 101147637
RN  - 0 (Hypoglycemic Agents)
RN  - 9100L32L2N (Metformin)
SB  - IM
MH  - Aged
MH  - Asian People
MH  - Cardiovascular Diseases/*epidemiology
MH  - Cohort Studies
MH  - Coronary Disease/epidemiology
MH  - Diabetes Mellitus, Type 2/*drug therapy
MH  - Female
MH  - Follow-Up Studies
MH  - Heart Failure/epidemiology
MH  - Hong Kong
MH  - Humans
MH  - Hypoglycemic Agents/*therapeutic use
MH  - Male
MH  - Metformin/*therapeutic use
MH  - Middle Aged
MH  - Mortality
MH  - Proportional Hazards Models
MH  - Renal Insufficiency, Chronic/epidemiology
MH  - Retrospective Studies
MH  - Risk Reduction Behavior
MH  - Stroke/epidemiology
MH  - Treatment Outcome
PMC - PMC4600251
EDAT- 2015/10/11 06:00
MHDA- 2016/07/09 06:00
PMCR- 2015/10/09
CRDT- 2015/10/11 06:00
PHST- 2015/08/07 00:00 [received]
PHST- 2015/10/02 00:00 [accepted]
PHST- 2015/10/11 06:00 [entrez]
PHST- 2015/10/11 06:00 [pubmed]
PHST- 2016/07/09 06:00 [medline]
PHST- 2015/10/09 00:00 [pmc-release]
AID - 10.1186/s12933-015-0304-2 [pii]
AID - 304 [pii]
AID - 10.1186/s12933-015-0304-2 [doi]
PST - epublish
SO  - Cardiovasc Diabetol. 2015 Oct 9;14:137. doi: 10.1186/s12933-015-0304-2.