Evidence map›Paper›PMID 15699279›Full record

ArticleCirculation2005

Thiazolidinediones, metformin, and outcomes in older patients with diabetes and heart failure: an observational study.

Frederick A Masoudi, Silvio E Inzucchi, Yongfei Wang, Edward P Havranek, JoAnne M Foody, Harlan M Krumholz

Registry-linked trialOpen access · bronzeAbstract read
PubMed Publisher
In one paragraph

Article in Circulation, 2005. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02064881 (Effect of Metformin Glycinate on Postprandial Lipemia, Glycemic Control and Oxidation Markers in Type 2 Diabetes Patients), which is not on this map. Cited by 137 papers, 10 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
137citing papers in PubMed, 10 pooled it
19.1field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT02064881 phase2 / phase3unknown statusstarted 2015, after this paper: background citation

Effect of Metformin Glycinate on Postprandial Lipemia, Glycemic Control and Oxidation Markers in Type 2 Diabetes Patients

Ran2015Enrolled72Registered outcomes7Posted comparisons0ConditionsType 2 DiabetesArmsMetformin glycinate, Metformin hydrochloride
PMID 9742977PMID 21098347PMID 21471135PMID 22517736other papers from this trial
Open the trial in the graph
3 · Its place in the literature

Who cites it

137 citing papers in PubMed, 10 syntheses or guidelines pooled it, 458 citations in OpenAlex.

  1. Guideline
  2. Pooled it
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  6. Treatment of Diabetes in Older Adults: An Endocrine Society* Clinical Practice Guideline.The Journal of clinical endocrinology and metabolism · 2019
    Guideline
  7. Pooled it
  8. Pooled it
  9. Risk of fatal and nonfatal lactic acidosis with metformin use in type 2 diabetes mellitus.The Cochrane database of systematic reviews · 2010 · on this map
    Pooled it
  10. Pooled it
  11. Trial
  12. Trial
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  17. Review
  18. Influence of Metformin Discontinuation on Readmission Rate in Patients With Acute Heart Failure.Journal of community hospital internal medicine perspectives · 2024
    Article
  19. Article
  20. Article

77 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 4 institutions in 1 country.

Frederick A MasoudiDepartment of Medicine, Division of Cardiology MC 0960, Denver Health Medical Center, 777 Bannock St, Denver, CO 80204, USA. fred.masoudi@uchsc.edu
Silvio E Inzucchi
Yongfei Wang
Edward P Havranek
JoAnne M Foody
Harlan M Krumholz
Denver Health Medical Center · USArkansas Foundation for Medical Care · USUniversity of Colorado Denver · USUniversity of Colorado Health · US

Funding

HEART FAILURE &NORMAL SYSTOLIC FUNCTION IN OLDER ADULTSK08AG001011 · UNIVERSITY OF COLORADO DENVER · 2000 to 2004
$582k
Lipid Testing /Treatment in Older MI PatientsK08AG020623 · YALE UNIVERSITY · 2002 to 2005
$500k
NIA NIH HHS K08-AG01011NIA NIH HHS K08-AG20623
6 · The paper itself

Abstract

backgroundInsulin-sensitizing drugs of the thiazolidinedione class and metformin are commonly prescribed to treat diabetes in patients with heart failure despite strong warnings from the Food and Drug Administration against this practice. Whether this results in adverse outcomes is unknown. METHODS AND

resultsWe conducted a retrospective cohort study of 16,417 Medicare beneficiaries with diabetes discharged after hospitalization with the principal discharge diagnosis of heart failure. The association between antidiabetic drug prescriptions and outcomes was assessed in multivariable hierarchical Cox proportional hazards models, with adjustment for patient, physician, and hospital variables and accounting for the clustering of patients within hospitals. The primary outcome of the study was time to death due to all causes. Secondary outcomes included time to readmission for all causes or for heart failure. Crude 1-year mortality rates were lower among the 2226 patients treated with a thiazolidinedione (30.1%) or the 1861 treated with metformin (24.7%) compared with that among the 12,069 treated with neither insulin-sensitizing drug (36.0%, P= or <0.0001 for both comparisons). In multivariable models, treatment with the thiazolidinediones (hazard ratio [HR] 0.87, 95% CI 0.80 to 0.94) or metformin (HR=0.87, 95% CI 0.78 to 0.97) was associated with significantly lower risks of death. There was no association with treatment with sulfonylureas (HR=0.99, 95% CI 0.91 to 1.08) or insulin (HR=0.96, 95% CI 0.88 to 1.05) and mortality. Admissions for all causes did not differ with either insulin sensitizer. There was a higher risk of readmission for heart failure with thiazolidinedione treatment (HR 1.06, 95% CI 1.00 to 1.09) and a lower risk with metformin treatment (HR 0.92, 95% CI 0.92 to 0.99).

conclusionsThis observational study suggests that thiazolidinediones and metformin are not associated with increased mortality and may improve outcomes in older patients with diabetes and heart failure. Randomized trials are warranted to corroborate these findings.

Indexed as

Diabetic AngiopathiesHypoglycemic AgentsMetforminThiazolidinedionesAgedCardiac Output, LowCohort StudiesContraindicationsDiabetes MellitusFemaleHumansMalePatient ReadmissionProportional Hazards ModelsRetrospective StudiesTreatment OutcomeHypoglycemic AgentsMetforminThiazolidinediones

Identifiers

PMID15699279
OpenAlexW2055769770

What Socratic holds

Texttitle and abstract
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.