Abstract 981: Metformin is Associated With a Low Mortality in Diabetes Patients With Heart Failure
Objectives: Concerns have been raised on the safety of metformin in patients with heart failure, but this has yet not been fully clarified. We therefore examined the prognostic effect of metformin in diabetes patients hospitalized for the first time with heart failure and treated with metformin, insulin, and/or sulfonylureas.
Methods and results: All patients aged ≥30 years with a first-time hospitalization for heart failure between 1997 and 2006 were identified from nationwide registers and followed until the end of 2006. Patients who claimed at least one prescription of metformin, insulin, and/or sulfonylureas during 180 days prior to hospitalization were included (n=14251) and grouped according to baseline use (Figure 1⇓). The 30 days- and long term relative risk of all-cause mortality was calculated by Cox proportional-hazard models, adjusted for age, gender, calendar year of hospitalization, concomitant cardiovascular pharmacotherapy and co-morbidities. The median observation time was 536 days (IQR 1162 days) and we registered 2221 (16%) and 9006 (63%) deaths during the first 30 days and the whole observation period, respectively. Adjusted relative risk of death associated with the different treatment modalities are presented in Figure 1⇓. Compared to sulfonylureas, metformin was not associated with increased risk of death.
Conclusion: Compared to use of sulfonylureas, use of metformin is not associated with increased risk of death in diabetes patients with heart failure.