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. 2013 Dec 1;7(6):417-422.
doi: 10.1007/s12170-013-0355-4.

Metformin in Diabetic Patients with Heart Failure: Safe and Effective?

Ijeoma Ananaba Ekeruo  1 , Amirreza Solhpour  1 , Heinrich Taegtmeyer  1
Affiliations

Metformin in Diabetic Patients with Heart Failure: Safe and Effective?

Ijeoma Ananaba Ekeruo et al. Curr Cardiovasc Risk Rep. .

Abstract

Management of diabetic patients with heart failure is a complex endeavor. The initial reluctance to use metformin in these patients has given way to a broader acceptance after clinical trials and meta-analyses have revealed that some of the insulin-sensitizing agents lead to adverse cardiovascular events. We have proposed that an increase of substrate uptake by the insulin-resistant heart is detrimental because the heart is already flooded with fuel. In light of this evidence, metformin offers a unique safety profile in the patient with diabetes and heart failure. Our article expands on the use of metformin in patients with heart failure. We propose that the drug targets both the source as well as the destination (in this case the heart) of excess fuel. We consider treatment of diabetic heart failure patients with metformin both safe and effective.

Keywords: Anti-diabetic Drugs; Heart Failure; Type 2 Diabetes Mellitus.

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Conflict of interest statement

Compliance with Ethics Guidelines

Conflict of Interest

Heinrich Taegtmeyer, Ijeoma Ananaba Ekeruo and Amirreza Solhpour declare that they have no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

Figures

Figure
Figure
Kaplan-Meier curves and metformin treatment in a propensity score-matched, national cohort of 6185 patients with heart failure and diabetes treated in ambulatory clinics at Veterans Administration medical centers. In this cohort, 561 patients were treated with metformin. Metformin treatment was associated with lower rates of mortality. Probability value = 0.01 (log-rank). From Aguilar et al (24), with permission from the authors and publisher.
See this image and copyright information in PMC

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