Clinical outcomes in type 2 diabetes patients with chronic heart failure treated with metformin: a meta-analysis

IF 3.7 3区医学 Q2 Medicine Endocrine Pub Date : 2024-09-15 DOI:10.1007/s12020-024-04025-6

Wenxia Huang, Rongchen Zhao

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Abstract

Objective

To explore outcomes of metformin (Met) as an antihyperglycemic agent in patients with type 2 diabetes mellitus (T2DM) combined with chronic heart failure (CHF).

Methods

This article employed a meta-analysis approach to systematically search several databases. Stata 15.1 software was employed for statistical analysis.

Results

This meta-analysis encompassed 15 randomized controlled trials, involving 20,595 patients with T2DM and CHF. The results revealed that in comparison to the non-Met group, the Met group exhibited a significantly reduced risk of all-cause mortality (RR = 0.72, 95%CI: 0.60–0.87) and a notably lower risk of cardiovascular mortality (RR = 0.52, 95%CI:0.29–0.92). However, there was no significant difference in the risk of hospitalization due to heart failure (RR = 0.85, 95%CI: 0.70–1.04). Furthermore, the Met group demonstrated significant improvements in NT-proBNP levels compared to the non-Met group (WMD = −132.91, 95%CI: −173.03, −92.79). 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.

Conclusion

In individuals with T2DM and CHF, the use of Met is linked to a decreased likelihood of all-cause mortality and cardiovascular-related mortality. Furthermore, it can enhance cardiac function in CHF patients without elevating the risk of hospitalization due to heart failure, establishing its safety and potential benefits.

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使用二甲双胍治疗慢性心力衰竭的 2 型糖尿病患者的临床疗效：一项荟萃分析

目的探讨二甲双胍（Met）作为一种降糖药物对 2 型糖尿病（T2DM）合并慢性心力衰竭（CHF）患者的治疗效果。结果这项荟萃分析包括 15 项随机对照试验，涉及 20,595 名 T2DM 和 CHF 患者。结果显示，与非麦特组相比，麦特组的全因死亡风险显著降低（RR = 0.72，95%CI：0.60-0.87），心血管死亡风险明显降低（RR = 0.52，95%CI：0.29-0.92）。不过，因心力衰竭住院的风险没有明显差异（RR = 0.85，95%CI：0.70-1.04）。此外，与非 Met 组相比，Met 组的 NT-proBNP 水平有明显改善（WMD = -132.91，95%CI：-173.03, -92.79）。结论在患有 T2DM 和慢性心力衰竭的患者中，使用 Met 可降低全因死亡率和心血管相关死亡率。此外，它还能增强慢性心力衰竭患者的心脏功能，而不会增加因心力衰竭而住院的风险，从而确定了它的安全性和潜在益处。

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来源期刊

Endocrine 医学-内分泌学与代谢

CiteScore

6.40

自引率

5.40%

发文量

期刊介绍： Well-established as a major journal in today’s rapidly advancing experimental and clinical research areas, Endocrine publishes original articles devoted to basic (including molecular, cellular and physiological studies), translational and clinical research in all the different fields of endocrinology and metabolism. Articles will be accepted based on peer-reviews, priority, and editorial decision. Invited reviews, mini-reviews and viewpoints on relevant pathophysiological and clinical topics, as well as Editorials on articles appearing in the Journal, are published. Unsolicited Editorials will be evaluated by the editorial team. Outcomes of scientific meetings, as well as guidelines and position statements, may be submitted. The Journal also considers special feature articles in the field of endocrine genetics and epigenetics, as well as articles devoted to novel methods and techniques in endocrinology. Endocrine covers controversial, clinical endocrine issues. Meta-analyses on endocrine and metabolic topics are also accepted. Descriptions of single clinical cases and/or small patients studies are not published unless of exceptional interest. However, reports of novel imaging studies and endocrine side effects in single patients may be considered. Research letters and letters to the editor related or unrelated to recently published articles can be submitted. Endocrine covers leading topics in endocrinology such as neuroendocrinology, pituitary and hypothalamic peptides, thyroid physiological and clinical aspects, bone and mineral metabolism and osteoporosis, obesity, lipid and energy metabolism and food intake control, insulin, Type 1 and Type 2 diabetes, hormones of male and female reproduction, adrenal diseases pediatric and geriatric endocrinology, endocrine hypertension and endocrine oncology.