PMID- 29862487
OWN - NLM
STAT- MEDLINE
DCOM- 20181217
LR  - 20181217
IS  - 1897-4279 (Electronic)
IS  - 0022-9032 (Linking)
VI  - 76
IP  - 9
DP  - 2018
TI  - The influence of metformin and the presence of type 2 diabetes mellitus on 
      mortality and hospitalisation in patients with heart failure.
PG  - 1336-1343
LID - 10.5603/KP.a2018.0127 [doi]
AB  - BACKGROUND: Metformin is one of the antihyperglycaemic drugs, reducing the risk 
      of major cardiovascular events, including fatal ones. Although it is formally 
      contraindicated in moderate and severe functional stages of heart failure (HF), 
      it is commonly used in patients with concomitant type 2 diabetes mellitus (T2DM). 
      AIM: We sought to evaluate the effect of metformin and T2DM on total mortality 
      and hospitalisation rates in patients with HF. METHODS: This retrospective 
      analysis included 1030 adult patients (> 18 years) with HF from the Polish 
      section of the HF Long-Term Registry (enrolled between 2011 and 2014). Patients 
      with T2DM (n = 350) were identified and divided into two groups: those receiving 
      metformin and those not. Both groups were subjected to one-year follow-up. 
      RESULTS: Mean patient age was 65.3 +/- 13.5 years, with the predominance of male 
      sex (n = 726) and obesity (mean body mass index 30.3 +/- 5.5 kg/m2) and mean left 
      ventricular ejection fraction was 34.3% +/- 14.1%. Among patients with T2DM (n = 
      350) only 135 (38.6%) were treated with metformin. During one-year follow-up, 128 
      patients with HF died, of whom 53 had T2DM (15.1% vs. 10.9%, hazard ratio [HR] 
      0.89, 95% confidence interval [CI] 0.87-0.91, p = 0.045). Metformin was 
      associated with a lower mortality rate compared to other antihyperglycaemic 
      agents (9.6% vs. 18.6%, HR 0.85; 95% CI 0.81-0.89, p = 0.023). There were no 
      significant differences in the hospitalisation rate, including that due to HF 
      decompensation, among patients treated with metformin and the remainder (53.5% 
      vs. 40.0%, respectively HR 0.93, 95% CI 0.82-1.04, p = 0.433). CONCLUSIONS: 
      Metformin treatment in patients with different degrees of HF and T2DM is 
      associated with a reduction in mortality and does not affect the hospitalisation 
      rate.
FAU - Retwinski, Arkadiusz
AU  - Retwinski A
AD  - Department of Cardiology, Chair of Cardiology, Cardiac Surgery, and Vascular 
      Diseases, Medical University of Lodz, Lodz, Poland. aretwinski@gmail.com.
FAU - Kosmalski, Marcin
AU  - Kosmalski M
FAU - Crespo-Leiro, Marisa
AU  - Crespo-Leiro M
FAU - Maggioni, Aldo
AU  - Maggioni A
FAU - Opolski, Grzegorz
AU  - Opolski G
FAU - Ponikowski, Piotr
AU  - Ponikowski P
FAU - Polonski, Lech
AU  - Polonski L
FAU - Jankowska, Ewa
AU  - Jankowska E
FAU - Drzewoski, Jerzy
AU  - Drzewoski J
FAU - Drozdz, Jaroslaw
AU  - Drozdz J
LA  - eng
PT  - Journal Article
DEP - 20180604
PL  - Poland
TA  - Kardiol Pol
JT  - Kardiologia polska
JID - 0376352
RN  - 0 (Hypoglycemic Agents)
RN  - 9100L32L2N (Metformin)
SB  - IM
MH  - Aged
MH  - Diabetes Mellitus, Type 2/complications/*drug therapy
MH  - Female
MH  - Heart Failure/*etiology/mortality
MH  - *Hospitalization
MH  - Humans
MH  - Hypoglycemic Agents/pharmacology/therapeutic use
MH  - Male
MH  - Metformin/*pharmacology/therapeutic use
MH  - Middle Aged
MH  - Poland
MH  - Registries
MH  - Retrospective Studies
MH  - Stroke Volume
OTO - NOTNLM
OT  - heart failure
OT  - metformin
OT  - pharmacology
OT  - type 2 diabetes mellitus
EDAT- 2018/06/05 06:00
MHDA- 2018/12/18 06:00
CRDT- 2018/06/05 06:00
PHST- 2018/02/19 00:00 [received]
PHST- 2018/05/28 00:00 [accepted]
PHST- 2018/05/25 00:00 [revised]
PHST- 2018/06/05 06:00 [pubmed]
PHST- 2018/12/18 06:00 [medline]
PHST- 2018/06/05 06:00 [entrez]
AID - VM/OJS/KP/12005 [pii]
AID - 10.5603/KP.a2018.0127 [doi]
PST - ppublish
SO  - Kardiol Pol. 2018;76(9):1336-1343. doi: 10.5603/KP.a2018.0127. Epub 2018 Jun 4.