Prognostic impact of metformin in patients with type 2 diabetes mellitus and acute heart failure: Combined analysis of the EAHFE and RICA registries

Patients with diabetes mellitus (DM) and heart failure (HF) have a worse prognosis despite therapeutic advances in both diseases. Sodium-glucose co-transporter type 2 and GLP-1 receptor agonists have shown cardiovascular benefits and have been positioned as the first step in the treatment of DM in p...

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Bibliographic Details
Published in:Revista clínica espanõla (English edition) 2023-11, Vol.223 (9), p.542-551
Main Authors: Povar-Echeverría, M., Méndez-Bailón, M., Martín-Sánchez, F.J., Montero-Pérez-Barquero, M., Carles-Trullàs, J., Miró, Ò.
Format: Article
Language:English
Subjects:
Diabetes mellitus
Diabetes Mellitus, Type 2 - complications
Diabetes Mellitus, Type 2 - drug therapy
Heart Failure
Humans
Hypoglycemic Agents - therapeutic use
Insuficiencia cardiaca
Metformin
Metformin - therapeutic use
Metformina
Prognosis
Prognostic
Pronóstico
Prospective Studies
Registries
Registro
Registry
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Summary:Patients with diabetes mellitus (DM) and heart failure (HF) have a worse prognosis despite therapeutic advances in both diseases. Sodium-glucose co-transporter type 2 and GLP-1 receptor agonists have shown cardiovascular benefits and have been positioned as the first step in the treatment of DM in patients with HF or high cardiovascular risk. However, in the pivotal trials the majority of patients received concomitant treatment with metformin. Randomized clinical trials have not yet been developed to assess the prognostic impact of metformin at the cardiovascular level. Our objective was to analyze whether patients with DM and acute HF who receive treatment with metformin at the time of discharge have a better prognosis at one year of follow-up. Prospective cohort trial using the combined analysis of the two main Spanish HF registries, the EAHFE Registry (Epidemiology of Acute Heart Failure in Emergency Departments) and the RICA (National Registry of Patients with Heart Failure). Of a total of 4403 patients with DM type 2, 33% (1453) received treatment with metformin. This group presents significantly lower mortality after one year of treatment (22 versus 32%; Log Rank test P 
ISSN:2254-8874
2254-8874
DOI:10.1016/j.rceng.2023.09.007