Metformin was associated with lower all-cause mortality in type 2 diabetes with acute coronary syndrome: A Nationwide registry with propensity score-matched analysis

Jong, Chien-Boon; Chen, Kuan‐Yu; Hsieh, Mu-Yang; Su, Fang-Ying; Wu, Chih‐Cheng; Voon, Wen‐Chol; Hsieh, I‐Chang; Shyu, Kou‐Gi; Chong, Jun-Ted; Lin, Wei‐Shiang; Hsu, Chih‐Neng; Ueng, Kwo‐Chang; Lai, Chao‐Lun

doi:10.1016/j.ijcard.2019.03.021

Cited by 21 publications

(19 citation statements)

References 28 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…UK Prospective Diabetes Study (UKPDS) Group,” 1998). Ample observational evidence supports survival benefits in people with diabetes treated with metformin, including when compared to people without diabetes (Bannister et al, 2014; Campbell et al, 2017; Jong et al, 2019; Ritsinger et al, 2020).…”

Section: Resultsmentioning

confidence: 99%

“…SGLT2i demonstrated the most robust clinical evidence for reduction of death from any cause and CVD, in patients with or without T2D, heart failure, and chronic kidney disease (CKD) (Cavender et al, 2018;Heerspink et al, 2020;Neal et al, 2017;Packer et al, 2020;Perkovic et al, 2019) Group," 1998). Ample observational evidence supports survival benefits in people with diabetes treated with metformin, including when compared to people without diabetes (Bannister et al, 2014;Campbell et al, 2017;Jong et al, 2019;Ritsinger et al, 2020).…”

Section: Mortalitymentioning

confidence: 99%

See 1 more Smart Citation

Geroscience‐guided repurposing of FDA‐approved drugs to target aging: A proposed process and prioritization

et al. 2022

View full text Add to dashboard Cite

Common chronic diseases represent the greatest driver of rising healthcare costs, as well as declining function, independence, and quality of life. Geroscience-guided approaches seek to delay the onset and progression of multiple chronic conditions by targeting fundamental biological pathways of aging. This approach is more likely to improve overall health and function in old age than treating individual diseases, by addressing aging the largest and mostly ignored risk factor for the leading causes of morbidity in older adults. Nevertheless, challenges in repurposing existing and moving newly discovered interventions from the bench to clinical care have impeded the progress of this potentially transformational paradigm shift. In this article, we propose the creation of a standardized process for evaluating FDA-approved medications for their geroscience potential. Criteria for systematically evaluating the existing literature that spans from animal models to human studies will permit the prioritization of efforts and financial investments for translating geroscience and allow immediate progress on the design of the next Targeting Aging with MEtformin (TAME)-like study involving such candidate gerotherapeutics.

show abstract

Section: Resultsmentioning

confidence: 99%

Section: Mortalitymentioning

confidence: 99%

Geroscience‐guided repurposing of FDA‐approved drugs to target aging: A proposed process and prioritization

et al. 2022

View full text Add to dashboard Cite

show abstract

“…In patients with established CAD, metformin was associated with a 29% reduction in cardiovascular mortality (HR 0.81 [95% CI 0.79, 0.84], p < 0.001) and a 33% reduction in all-cause mortality (HR 0.67 [95% CI 0.60, 0.75], p < 0.001) [39]. Furthermore, in a propensity-matched study of patients followed up after an acute coronary syndrome (ACS), metformin was associated with a 50% reduction (HR 0.50 [95% CI 0.26, 0.95], p = 0.035) in all-cause mortality [40]. However, in an analysis of patients treated with metformin presenting with their first ACS, metformin was associated with increased MACE (HR 1.13 [95% CI 1.03, 1.23], p = 0.006) but in those patients who survived beyond 30-days after the index event, metformin was not associated with MACE (HR 1.06 [95% CI 0.95, 1.17, p = 0.305) [41].…”

Section: Metformin In T2dm and Cardiovascular Diseasementioning

confidence: 99%

Metformin treatment in heart failure with preserved ejection fraction: a systematic review and meta-regression analysis

Halabi

Sen

Huynh

et al. 2020

Cardiovasc Diabetol

View full text Add to dashboard Cite

Background: Observational series suggest a mortality benefit from metformin in the heart failure (HF) population. However, the benefit of metformin in HF with preserved ejection fraction (HFpEF) has yet to be explored. We performed a systematic review and meta-analysis to identify whether variation in EF impacts mortality outcomes in HF patients treated with metformin. Methods: MEDLINE and EMBASE were searched up to October 2019. Observational studies and randomised trials reporting mortality in HF patients and the proportion of patients with an EF > 50% at baseline were included. Other baseline variables were used to assess for heterogeneity in treatment outcomes between groups. Regression models were used to determine the interaction between metformin and subgroups on mortality. Results: Four studies reported the proportion of patients with a preserved EF and were analysed. Metformin reduced mortality in both preserved or reduced EF after adjustment with HF therapies such as angiotensin converting enzyme inhibitors (ACEi) and beta-blockers (β = − 0.2 [95% CI − 0.3 to − 0.1], p = 0.02). Significantly greater protective effects were seen with EF > 50% (p = 0.003). Metformin treatment with insulin, ACEi and beta-blocker therapy were also shown to have a reduction in mortality (insulin p = 0.002; ACEi p < 0.001; beta-blocker p = 0.017), whereas female gender was associated with worse outcomes (p < 0.001). Conclusions: Metformin treatment is associated with a reduction in mortality in patients with HFpEF.

show abstract

“…Later studies indicate that metformin has beneficial effects on CVD even in those with established risk factors or in those with longer duration of diabetes. In data looking at individuals with T2D and established acute coronary syndrome (ACS), metformin users were found to have a lower all-cause mortality rate (hazard ratio (HR) 0.50, 95% CI 0.26, 0.95; p = 0.0346) in the primary analysis compared to non-metformin users [27]. A large trial of 390 individuals treated with insulin investigated whether metformin addition has sustained beneficial metabolic and cardiovascular effects compared to placebo in individuals with T2D [28].…”

Section: Participant Characteristicsmentioning

confidence: 99%

Where Does Metformin Stand in Modern Day Management of Type 2 Diabetes?

et al. 2020

View full text Add to dashboard Cite

Metformin is the most commonly used glucose-lowering therapy (GLT) worldwide and remains the first-line therapy for newly diagnosed individuals with type 2 diabetes (T2D) in management algorithms and guidelines after the UK Prospective Diabetes Study (UKPDS) showed cardiovascular mortality benefits in the overweight population using metformin. However, the improved Major Adverse Cardiovascular Events (MACE) realised in some of the recent large cardiovascular outcomes trials (CVOTs) using sodium-glucose co-transporter 2 inhibitors (SGLT2i) and glucagon-like peptide-1 receptor agonists (GLP-1RA) have challenged metformin’s position as a first-line agent in the management of T2D. Many experts now advocate revising the existing treatment algorithms to target atherosclerotic cardiovascular disease (ASCVD) and improving glycaemic control as a secondary aim. In this review article, we will revisit the major cardiovascular outcome data for metformin and include a critique of the UKPDS data. We then review additional factors that might be pertinent to metformin’s status as a first-line agent and finally answer key questions when considering metformin’s role in the modern-day management of T2D.

show abstract

Metformin was associated with lower all-cause mortality in type 2 diabetes with acute coronary syndrome: A Nationwide registry with propensity score-matched analysis

Cited by 21 publications

References 28 publications

Geroscience‐guided repurposing of FDA‐approved drugs to target aging: A proposed process and prioritization

Geroscience‐guided repurposing of FDA‐approved drugs to target aging: A proposed process and prioritization

Metformin treatment in heart failure with preserved ejection fraction: a systematic review and meta-regression analysis

Where Does Metformin Stand in Modern Day Management of Type 2 Diabetes?

Contact Info

Product

Resources

About