Metformin Associated with Lower Mortality Rates in Diabetes Patients With Heart Failure: Study

"In a meta-analysis involving 20,595 patients with T2DM and CHF, those treated with metformin exhibited a 28% reduction in the risk of all-cause mortality and a 48% lower risk of cardiovascular death compared to those not on metformin. While metformin did not impact hospitalization rates for heart failure, it was associated with improved NT-proBNP levels, suggesting enhanced cardiac function," the researchers reported.

Chronic heart failure is a prevalent condition among individuals with T2DM, contributing to significant morbidity and mortality. Traditionally, the management of CHF in diabetic patients has posed challenges, particularly regarding the choice of pharmacological interventions. Metformin, a first-line treatment for T2DM, has garnered attention for its potential cardiovascular benefits.

Against the above background, Wenxia Huang & Rongchen Zhao from China aimed to investigate the effects of metformin (Met) as an antihyperglycemic treatment in patients with type 2 diabetes mellitus who also have chronic heart failure.

This article utilized a meta-analysis methodology to conduct a systematic search across multiple databases. Statistical analysis was performed using Stata 15.1 software.

Based on the study, the researchers reported the following findings:

• The meta-analysis encompassed 15 randomized controlled trials involving 20,595 patients with T2DM and CHF.
• The results revealed that compared to the non-Met group, the Met group exhibited a significantly reduced risk of all-cause mortality (RR = 0.72) and a notably lower risk of cardiovascular mortality (RR = 0.52).
• There was no significant difference in the risk of hospitalization due to heart failure (RR = 0.85).
• The Met group demonstrated significant improvements in NT-proBNP levels compared to the non-Met group (WMD = −132.91).
• Regarding the enhancement of Left Ventricular Ejection Fraction and Left Ventricular End-Diastolic Dimension levels, no statistically significant differences were observed between the two groups.

"Our study showed that in individuals with type 2 diabetes and chronic heart failure, the use of metformin is associated with a reduced risk of all-cause and cardiovascular-related mortality. Additionally, it may improve cardiac function in CHF patients without increasing the risk of hospitalization for heart failure, highlighting its safety and potential advantages," the researchers concluded.

As healthcare providers seek to improve outcomes for patients with these interconnected conditions, metformin may emerge as a cornerstone of therapy, offering hope for enhanced quality of life and longevity.

Reference:

Huang, W., Zhao, R. Clinical outcomes in type 2 diabetes patients with chronic heart failure treated with metformin: a meta-analysis. Endocrine (2024). https://doi.org/10.1007/s12020-024-04025-6