What does this research mean for the field?

Metformin treatment is not independently associated with improved overall clinical outcomes in patients with type 2 diabetes mellitus and HFpEF, but it is associated with reduced all-cause mortality in the subgroup of patients with poor glycemic control (HbA1c ≥7%). Novelty: ClaimNovelty.NOVEL_FINDING. Consensus alignment: ConsensusAlignment.NEUTRAL.

March 12, 2021Frontiers in Cardiovascular MedicineOpen Access

The Association Between Metformin Treatment and Outcomes in Type 2 Diabetes Mellitus Patients With Heart Failure With Preserved Ejection Fraction: A Retrospective Study

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Why the study?

The association between metformin treatment and clinical outcomes in patients with type 2 diabetes mellitus and HFpEF was unknown.

Does metformin reduce all-cause mortality and hospitalizations in patients with type 2 diabetes mellitus and heart failure with preserved ejection fraction?

Population

372 hospitalized T2DM patients with HFpEF

Comparison

Metformin vs non-metformin

Design

Retrospective cohort study

Follow-up

Median 47 months

Authors

JWJianfang WangInstitute of Soil and Water Conservation YLYi LüJiangsu University XMXinjia MinCommunication University of Zhejiang

Discussion

Member takes

Implication

Metformin was not independently linked to lower mortality in T2DM-HFpEF overall; leaves open possible benefit in HbA1c ≥7% subgroup for prospective trials.

Key Points

To evaluate the association between metformin use and adverse clinical outcomes in patients with type 2 diabetes mellitus and heart failure with preserved ejection fraction.
Retrospective cohort study of 372 hospitalized type 2 diabetes mellitus patients with heart failure with preserved ejection fraction (113 receiving metformin, 259 not receiving metformin) followed for a median of 47 months.
Outcomes assessed included all-cause mortality, cardiovascular death, all-cause hospitalization, and heart failure hospitalization analyzed via multivariable Cox regression.
All-cause death occurred in 11 patients (2.49% per patient-year) taking metformin compared with 56 patients (5.52% per patient-year) not taking metformin (P = 0.031), but metformin was not an independent predictor in multivariable analysis (HR = 0.682, 95% CI 0.346–1.345; P = 0.269).
In the subgroup with poor glycemic control (HbA1c ≥7%), metformin use was significantly associated with reduced all-cause mortality (HR = 0.339, 95% CI 0.117–0.997; P = 0.045), corresponding to a 4-year number needed to treat of 8.

Structured PICO

Does metformin reduce all-cause mortality and hospitalizations in patients with type 2 diabetes mellitus and heart failure with preserved ejection fraction?

Population

372 hospitalized patients with type 2 diabetes mellitus (T2DM) and heart failure with preserved ejection fraction (HFpEF)

Intervention

Metformin

Comparator

Non-metformin

Outcome

All-cause mortality, cardiovascular death, all-cause hospitalization, and heart failure hospitalizationhard clinical

Metformin does not independently reduce all-cause mortality in the overall population of T2DM patients with HFpEF, but may offer a mortality benefit in those with poor glycemic control (HbA1c ≥7%).

Cite This Study

Wang et al. (2021) studied this question.

synapsesocial.com/papers/6a1d41b933e2df9c962f3464 https://doi.org/10.3389/fcvm.2021.648212

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Implication

Metformin was not independently linked to lower mortality in T2DM-HFpEF overall; leaves open possible benefit in HbA1c ≥7% subgroup for prospective trials.

The Association Between Metformin Treatment and Outcomes in Type 2 Diabetes Mellitus Patients With Heart Failure With Preserved Ejection Fraction: A Retrospective Study

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

The Association Between Metformin Treatment and Outcomes in Type 2 Diabetes Mellitus Patients With Heart Failure With Preserved Ejection Fraction: A Retrospective Study

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Also Consider

Also Consider