Evidence map›Paper›PMID 16186261›Full record

ArticleDiabetes care2005

Improved clinical outcomes associated with metformin in patients with diabetes and heart failure.

Dean T Eurich, Sumit R Majumdar, Finlay A McAlister, Ross T Tsuyuki, Jeffrey A Johnson

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

Article in Diabetes care, 2005. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT00325910 (Patients With Heart Failure ANd Type 2 Diabetes Treated With Placebo Or Metformin), which is not on this map. Cited by 123 papers, 6 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
123citing papers in PubMed, 6 pooled it
12.1field-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.

NCT00325910 phase3terminatedstarted 2006, after this paper: background citation

Patients With Heart Failure ANd Type 2 Diabetes Treated With Placebo Or Metformin (PHANTOM) Pilot Study

Ran2006Enrolled100Registered outcomes6Posted comparisons0ConditionsDiabetes Mellitus, Type 2, Heart Failure, CongestiveArmsMetformin
Open the trial in the graph
3 · Its place in the literature

Who cites it

123 citing papers in PubMed, 6 syntheses or guidelines pooled it, 418 citations in OpenAlex.

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  6. 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
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63 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

5 authors at 1 institution in 1 country.

Dean T EurichInstitute of Health Economics, Edmonton, Alberta, Canada.
Sumit R Majumdar
Finlay A McAlister
Ross T Tsuyuki
Jeffrey A Johnson
Institute of Health Economics · CA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveMetformin is considered contraindicated in patients with heart failure because of concerns over lactic acidosis, despite increasing evidence of potential benefit. The aim of this study was to evaluate the association between metformin and clinical outcomes in patients with heart failure and type 2 diabetes. RESEARCH DESIGN AND

methodsUsing the Saskatchewan Health databases, 12,272 new users of oral antidiabetic agents were identified between the years 1991 and 1996. Subjects with incident heart failure (n = 1,833) were identified through administrative records based on ICD-9 code 428 and grouped according to antidiabetic therapy: metformin monotherapy (n = 208), sulfonylurea monotherapy (n = 773), or combination therapy (n = 852). Multivariate Cox proportional hazards models were used to assess differences in all-cause mortality, all-cause hospitalization, and the combination (i.e., all-cause hospitalization or mortality).

resultsAverage age of subjects was 72 years, 57% were male, and average follow-up was 2.5 +/- 2.0 (SD) years. Compared with sulfonylurea therapy, fewer deaths occurred in subjects receiving metformin: 404 (52%) for sulfonylurea monotherapy versus 69 (33%) for metformin monotherapy (hazard ratio [HR] 0.70 [95% CI 0.54-0.91]) and 263 (31%) for combination therapy (0.61 [0.52-0.72]). A reduction in deaths or hospitalizations was also observed: 658 (85%) for sulfonylurea monotherapy versus 160 (77%) for metformin monotherapy (0.83 [0.70-0.99]) and 681 (80%) for combination therapy (0.86 [0.77-0.96]). There was no difference in time to first hospitalization between study groups.

conclusionsMetformin, alone or in combination, in subjects with heart failure and type 2 diabetes was associated with lower morbidity and mortality compared with sulfonylurea monotherapy.

Indexed as

AgedAged, 80 and overCohort StudiesDatabases, FactualDiabetes Mellitus, Type 2FemaleHeart FailureHospitalizationHumansHypoglycemic AgentsMaleMetforminMiddle AgedMorbiditySaskatchewanSurvival AnalysisHypoglycemic AgentsMetformin

Identifiers

PMID16186261
OpenAlexW2125191390

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.