Metformin therapy in patients with diabetes mellitus is associated with a reduced risk of vasculopathy and cardiovascular mortality after heart transplantation
| العنوان: | Metformin therapy in patients with diabetes mellitus is associated with a reduced risk of vasculopathy and cardiovascular mortality after heart transplantation |
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| المؤلفون: | Enrique Z. Fisman, Leonid Sternik, Yael Peled, Elad Maor, Robert Klempfner, Sergei Amunts, Alexander Tenenbaum, Jacob Lavee, Eilon Ram, Tal Ovdat |
| المصدر: | Cardiovascular Diabetology, Vol 18, Iss 1, Pp 1-8 (2019) Cardiovascular Diabetology |
| بيانات النشر: | BMC, 2019. |
| سنة النشر: | 2019 |
| مصطلحات موضوعية: | Adult, Male, medicine.medical_specialty, lcsh:Diseases of the circulatory (Cardiovascular) system, Time Factors, Cardiovascular mortality, endocrine system diseases, Endocrinology, Diabetes and Metabolism, medicine.medical_treatment, Coronary Artery Disease, Heart transplantation, Risk Assessment, Risk Factors, Cause of Death, Internal medicine, Diabetes mellitus, medicine, Humans, Hypoglycemic Agents, Survival analysis, Original Investigation, Retrospective Studies, Heart Failure, Type 1 diabetes, business.industry, Type 2 Diabetes Mellitus, Middle Aged, Cardiac allograft vasculopathy, medicine.disease, Metformin, Treatment Outcome, Diabetes Mellitus, Type 2, lcsh:RC666-701, Cohort, cardiovascular system, Population study, Female, Cardiology and Cardiovascular Medicine, business, medicine.drug |
| الوصف: | Background Cardiac allograft vasculopathy (CAV) is a major cause of morbidity and mortality following heart transplantation (HT). Reduced cardiovascular mortality and morbidity have been reported in non-HT patients treated with metformin. Given the high prevalence of type 2 diabetes mellitus (T2DM) in HT patients, we investigated the association between metformin therapy and cardiovascular outcomes after HT. Methods The study population comprised 103 DM patients who had undergone HT between 1994 and 2018 and were prospectively followed-up. We excluded from the study patients with type 1 diabetes mellitus. Fifty-five HT patients (53%) in the cohort were treated with metformin. Clinical data were recorded on prospectively designed forms. The primary outcomes included CAV, survival, and the combined end-point of CAV or cardiovascular mortality. Results Kaplan–Meier survival analysis showed that the CAV rate at 20 years of follow-up was lower in DM patients treated with metformin than in those who were not (30 vs. 65%; log-rank p = 0.044). Similarly, the combined risk of CAV or cardiovascular mortality was lower in the metformin-treated patients than in those not receiving metformin (32 vs. 68%; log rank p = 0.01). Consistently, multivariate analysis adjusted for age and comorbidities showed that metformin therapy was independently associated with a significant 90% reduction (95% confidence interval 0.02–0.46, p = 0.003) in the risk for the development of CAV, and a 91% reduction (95% confidence interval 0.02–0.42; p = 0.003) in the risk for CAV or cardiovascular mortality. Conclusions In diabetic HT patients, metformin therapy is independently associated with a significant reduction in the long-term risk for CAV and the combined end-point of CAV or cardiovascular mortality after HT. |
| اللغة: | English |
| تدمد: | 1475-2840 |
| الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::82feadb94048cb83f7529746cbfbe348Test http://link.springer.com/article/10.1186/s12933-019-0925-yTest |
| حقوق: | OPEN |
| رقم الانضمام: | edsair.doi.dedup.....82feadb94048cb83f7529746cbfbe348 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 14752840 |
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