Evidence map›Paper›PMID 21098347›Full record

ArticleArchives of internal medicine2010

Metformin use and mortality among patients with diabetes and atherothrombosis.

Ronan Roussel, Florence Travert, Blandine Pasquet, Peter W F Wilson, Sidney C Smith, Shinya Goto, Philippe Ravaud, Michel Marre, Avi Porath, Deepak L Bhatt and 2 more

Registry-linked trialAbstract readMulticenter Study
PubMed Publisher
In one paragraph

Article in Archives of internal medicine, 2010. 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 139 papers, 13 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
139citing papers in PubMed, 13 pooled it
–field-weighted citation impact
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 21471135PMID 15699279PMID 22517736other papers from this trial
Open the trial in the graph
3 · Its place in the literature

Who cites it

139 citing papers in PubMed, 13 syntheses or guidelines pooled it.

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

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

12 authors.

Ronan RousselINSERM, Department of Diabetology, Bichat Hospital, Paris, France. ronan.roussel@bch.aphp.fr
Florence Travert
Blandine Pasquet
Peter W F Wilson
Sidney C Smith
Shinya Goto
Philippe Ravaud
Michel Marre
Avi Porath
Deepak L Bhatt
P Gabriel Steg
Reduction of Atherothrombosis for Continued Health (REACH) Registry Investigators

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundMetformin is recommended in type 2 diabetes mellitus because it reduced mortality among overweight participants in the United Kingdom Prospective Diabetes Study when used mainly as a means of primary prevention. However, metformin is often not considered in patients with cardiovascular conditions because of concerns about its safety.

methodsWe assessed whether metformin use was associated with a difference in mortality among patients with atherothrombosis. The study sample comprised 19 691 patients having diabetes with established atherothrombosis participating in the Reduction of Atherothrombosis for Continued Health (REACH) Registry between December 1, 2003, and December 31, 2004, treated with or without metformin. Multivariable adjustment and propensity score were used to account for baseline differences. The main outcome measure was 2-year mortality.

resultsThe mortality rates were 6.3% (95% confidence interval [CI], 5.2%-7.4%) with metformin and 9.8% 8.4%-11.2%) without metformin; the adjusted hazard ratio (HR) was 0.76 (0.65-0.89; P < .001). Association with lower mortality was consistent among subgroups, noticeably in patients with a history of congestive heart failure (HR, 0.69; 95% CI, 0.54-0.90; P = .006), patients older than 65 years (0.77; 0.62-0.95; P = .02), and patients with an estimated creatinine clearance of 30 to 60 mL/min/1.73 m(2) (0.64; 95% CI, 0.48-0.86; P = .003) (to convert creatinine clearance to mL/s/m(2), multiply by 0.0167).

conclusionsMetformin use may decrease mortality among patients with diabetes when used as a means of secondary prevention, including subsets of patients in whom metformin use is not now recommended. Metformin use should be tested prospectively in this population to confirm its effect on survival.

Indexed as

AgedAged, 80 and overAge FactorsCerebrovascular DisordersCoronary Artery DiseaseCreatinineDiabetes Mellitus, Type 2FemaleFollow-Up StudiesHeart FailureHumansHypoglycemic AgentsMaleMetforminPeripheral Arterial DiseaseProportional Hazards ModelsCreatinineHypoglycemic AgentsMetformin

Identifiers

PMID21098347

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.