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The Association of Metformin With Heart Failure in Patients With Diabetes Mellitus Receiving Anthracycline Chemotherapy
BACKGROUND: The prevention of heart failure (HF) is an important issue in patients treated with anthracyclines. Metformin, widely used to treat diabetes mellitus (DM), protects from anthracycline-induced cardiotoxicity in vitro and in animal models. OBJECTIVES: The aim of our study was to test the a...
Autores principales: | , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Elsevier
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10635887/ https://www.ncbi.nlm.nih.gov/pubmed/37969650 http://dx.doi.org/10.1016/j.jaccao.2023.05.013 |
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author | Onoue, Takeshi Kang, Yu Lefebvre, Bénédicte Smith, Amanda M. Denduluri, Srinivas Carver, Joseph Fradley, Michael G. Chittams, Jesse Scherrer-Crosbie, Marielle |
author_facet | Onoue, Takeshi Kang, Yu Lefebvre, Bénédicte Smith, Amanda M. Denduluri, Srinivas Carver, Joseph Fradley, Michael G. Chittams, Jesse Scherrer-Crosbie, Marielle |
author_sort | Onoue, Takeshi |
collection | PubMed |
description | BACKGROUND: The prevention of heart failure (HF) is an important issue in patients treated with anthracyclines. Metformin, widely used to treat diabetes mellitus (DM), protects from anthracycline-induced cardiotoxicity in vitro and in animal models. OBJECTIVES: The aim of our study was to test the association of metformin with the occurrence of symptomatic HF in patients with DM receiving anthracyclines. METHODS: A total of 561 patients with DM received new anthracycline therapy between 2008 and 2021 in a tertiary care center; propensity score matching was used to compare patients with or without metformin treatment. The primary outcome was new onset symptomatic HF occurring within 1 year of the initiation of anthracyclines. RESULTS: A total of 315 patients (65 ± 11 years of age, 33.7% male) were included. Patients with and without metformin were well matched for age, sex, type of cancer, medications, and cardiovascular risk factors. Six patients treated with metformin and 17 matched patients developed HF within 1 year of anthracycline initiation. The incidence of HF in patients treated with metformin was lower than patients without metformin within 1 year after anthracyclines (cumulative incidence: 3.6% vs 10.5%; P = 0.022; HR: 0.35; 95% CI: 0.14-0.90; P = 0.029). The use of metformin (HR: 0.71; 95% CI: 0.50-1.00; P = 0.049), was also associated with lower mortality. CONCLUSIONS: The use of metformin was associated with a lower incidence of HF and overall mortality in patients with DM receiving anthracyclines. Our findings should be further confirmed by randomized control trials. |
format | Online Article Text |
id | pubmed-10635887 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Elsevier |
record_format | MEDLINE/PubMed |
spelling | pubmed-106358872023-11-15 The Association of Metformin With Heart Failure in Patients With Diabetes Mellitus Receiving Anthracycline Chemotherapy Onoue, Takeshi Kang, Yu Lefebvre, Bénédicte Smith, Amanda M. Denduluri, Srinivas Carver, Joseph Fradley, Michael G. Chittams, Jesse Scherrer-Crosbie, Marielle JACC CardioOncol Original Research BACKGROUND: The prevention of heart failure (HF) is an important issue in patients treated with anthracyclines. Metformin, widely used to treat diabetes mellitus (DM), protects from anthracycline-induced cardiotoxicity in vitro and in animal models. OBJECTIVES: The aim of our study was to test the association of metformin with the occurrence of symptomatic HF in patients with DM receiving anthracyclines. METHODS: A total of 561 patients with DM received new anthracycline therapy between 2008 and 2021 in a tertiary care center; propensity score matching was used to compare patients with or without metformin treatment. The primary outcome was new onset symptomatic HF occurring within 1 year of the initiation of anthracyclines. RESULTS: A total of 315 patients (65 ± 11 years of age, 33.7% male) were included. Patients with and without metformin were well matched for age, sex, type of cancer, medications, and cardiovascular risk factors. Six patients treated with metformin and 17 matched patients developed HF within 1 year of anthracycline initiation. The incidence of HF in patients treated with metformin was lower than patients without metformin within 1 year after anthracyclines (cumulative incidence: 3.6% vs 10.5%; P = 0.022; HR: 0.35; 95% CI: 0.14-0.90; P = 0.029). The use of metformin (HR: 0.71; 95% CI: 0.50-1.00; P = 0.049), was also associated with lower mortality. CONCLUSIONS: The use of metformin was associated with a lower incidence of HF and overall mortality in patients with DM receiving anthracyclines. Our findings should be further confirmed by randomized control trials. Elsevier 2023-08-29 /pmc/articles/PMC10635887/ /pubmed/37969650 http://dx.doi.org/10.1016/j.jaccao.2023.05.013 Text en © 2023 Published by Elsevier on behalf of the American College of Cardiology Foundation. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). |
spellingShingle | Original Research Onoue, Takeshi Kang, Yu Lefebvre, Bénédicte Smith, Amanda M. Denduluri, Srinivas Carver, Joseph Fradley, Michael G. Chittams, Jesse Scherrer-Crosbie, Marielle The Association of Metformin With Heart Failure in Patients With Diabetes Mellitus Receiving Anthracycline Chemotherapy |
title | The Association of Metformin With Heart Failure in Patients With Diabetes Mellitus Receiving Anthracycline Chemotherapy |
title_full | The Association of Metformin With Heart Failure in Patients With Diabetes Mellitus Receiving Anthracycline Chemotherapy |
title_fullStr | The Association of Metformin With Heart Failure in Patients With Diabetes Mellitus Receiving Anthracycline Chemotherapy |
title_full_unstemmed | The Association of Metformin With Heart Failure in Patients With Diabetes Mellitus Receiving Anthracycline Chemotherapy |
title_short | The Association of Metformin With Heart Failure in Patients With Diabetes Mellitus Receiving Anthracycline Chemotherapy |
title_sort | association of metformin with heart failure in patients with diabetes mellitus receiving anthracycline chemotherapy |
topic | Original Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10635887/ https://www.ncbi.nlm.nih.gov/pubmed/37969650 http://dx.doi.org/10.1016/j.jaccao.2023.05.013 |
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