Metformin Is Associated with Improved Survival and Decreased Cardiac Events with No Impact on Patency and Limb Salvage after Revascularization for Peripheral Arterial Disease

Metformin in patients with and without diabetes: a paradigm shift in cardiovascular disease management

“…The recent evidence pointing towards its therapeutic benefit in heart failure with persevered ejection fraction in clinical and preclinical studies underlines the need to explore the breadth of the pleiotropic systemic effects of metformin [70]. Recent study also reported that metformin offers therapeutic benefit during heart failure with preserved ejection fraction by lowering titin-based passive stiffness in mice model [71], is associated with improved survival and decreased incidence of adverse cardiac events in peripheral arterial disease patients [72] and with a lower below-the-knee arterial calcification score [73]. Moreover, metformin is able to prevent cardiac dysfunction in a murine model of adult congenital heart disease [70].…”

Position Paper on the Diagnosis and Treatment of Peripheral Arterial Disease (PAD) in People with Diabetes Mellitus

“…This is true even though the data is meagre in this respect. A recently published study again proves the positive effect on CV survival, but not on salvaging extremities and openness rate after peripheral revascularisation [20].…”

ESVM Guideline on peripheral arterial disease

“…Metformin is the first-line oral antidiabetic drug in diabetics with PAOD, although the data is thin in this respect. A recently published study again demonstrates the positive effect on CV survival, but not on extremity retention and patency after peripheral revasculaization [161].…”