Metformin as a Cardioprotective Agent: New Life for an Old Drug?

Despite metformin's established role in treating patients with diabetes, its exact mechanism of action remains unclear. Does metformin possess additional mechanisms of action in addition to its glucose-lowering effect? Although medications such as sodium-glucose cotransporter-2 inhibitors and glucagon-like peptide-1 receptor agonists have become increasingly popular among diabetic patients, clinical research on the benefits of metformin beyond its antiglycemic effects continues to emerge. Given the higher incidence of heart disease amongst diabetic patients, its cardioprotective actions are of particular interest. Recent evidence suggests that metformin exerts cardioprotective effects. In this review, we will explore how metformin's cardioprotective effects alleviate cardiac remodeling, hypertrophy, and fibrosis.