Evidence map›Paper›PMID 32157481›Full record

SynthesisHeart failure reviews2021

Metformin and heart failure-related outcomes in patients with or without diabetes: a systematic review of randomized controlled trials.

Phiwayinkosi V Dludla, Tawanda M Nyambuya, Rabia Johnson, Sonia Silvestri, Patrick Orlando, Sithandiwe E Mazibuko-Mbeje, Kwazi B Gabuza, Vuyolwethu Mxinwa, Kabelo Mokgalaboni, Luca Tiano and 3 more

Abstract readSystematic Review
PubMed Publisher
In one paragraph

Synthesis in Heart failure reviews, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
22citing papers in PubMed, 2 pooled it
3.7field-weighted citation impact, top 6% 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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

22 citing papers in PubMed, 2 syntheses or guidelines pooled it, 44 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Review
  4. Article
  5. Review
  6. Article
  7. Review
  8. The role of NETosis in heart failure.Heart failure reviews · 2024
    Review
  9. Article
  10. Article
  11. Review
  12. Review
  13. Article
  14. Article
  15. Review
  16. Energy metabolism homeostasis in cardiovascular diseases.Journal of geriatric cardiology : JGC · 2021
    Article
  17. Review
  18. Review
  19. The Hormetic Effect of Metformin: "Less Is More"?International journal of molecular sciences · 2021
    Review
  20. NETosis as a Pathogenic Factor for Heart Failure.Oxidative medicine and cellular longevity · 2021
    Review
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

13 authors at 6 institutions in 3 countries.

Phiwayinkosi V DludlaBiomedical Research and Innovation Platform, South African Medical Research Council, Tygerberg, 7505, South Africa. pdludla@mrc.ac.za.
Tawanda M NyambuyaSchool of Laboratory Medicine and Medical Sciences, College of Health Sciences, University of KwaZulu-Natal, Durban, 4000, South Africa.
Rabia JohnsonBiomedical Research and Innovation Platform, South African Medical Research Council, Tygerberg, 7505, South Africa.
Sonia SilvestriDepartment of Life and Environmental Sciences, Polytechnic University of Marche, 60131, Ancona, Italy.
Patrick OrlandoDepartment of Life and Environmental Sciences, Polytechnic University of Marche, 60131, Ancona, Italy.
Sithandiwe E Mazibuko-MbejeDivision of Medical Physiology, Faculty of Health Sciences, Stellenbosch University, Tygerberg, 7505, South Africa.
Kwazi B GabuzaBiomedical Research and Innovation Platform, South African Medical Research Council, Tygerberg, 7505, South Africa.
Vuyolwethu MxinwaSchool of Laboratory Medicine and Medical Sciences, College of Health Sciences, University of KwaZulu-Natal, Durban, 4000, South Africa.
Kabelo MokgalaboniSchool of Laboratory Medicine and Medical Sciences, College of Health Sciences, University of KwaZulu-Natal, Durban, 4000, South Africa.
Luca TianoDepartment of Life and Environmental Sciences, Polytechnic University of Marche, 60131, Ancona, Italy.
Christo J F MullerBiomedical Research and Innovation Platform, South African Medical Research Council, Tygerberg, 7505, South Africa.
Johan LouwBiomedical Research and Innovation Platform, South African Medical Research Council, Tygerberg, 7505, South Africa.
Bongani B NkambuleSchool of Laboratory Medicine and Medical Sciences, College of Health Sciences, University of KwaZulu-Natal, Durban, 4000, South Africa.
South African Medical Research Council · ZAMarche Polytechnic University · ITUniversity of KwaZulu-Natal · ZANamibia University of Science and Technology · NAStellenbosch University · ZAUniversity of Zululand · ZA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Metformin is considered a safe anti-hyperglycemic drug for patients with type 2 diabetes (T2D); however, information on its impact on heart failure-related outcomes remains inconclusive. The current systematic review explored evidence from randomized clinical trials (RCTs) reporting on the impact of metformin in modulating heart failure-related markers in patients with or without T2D. Electronic databases such as MEDLINE, Cochrane Library, and EMBASE were searched for eligible studies. Included studies were those assessing the use of metformin as an intervention, and also containing the comparison group on placebo, and all articles had to report on measurable heart failure-related indices in individuals with or without T2D. The modified Downs and Black checklist was used to evaluate the risk of bias. Overall, nine studies met the inclusion criteria, enrolling a total of 2486 patients. Although summarized evidence showed that metformin did not affect left ventricular function, this antidiabetic drug could improve myocardial oxygen consumption concomitant to reducing prominent markers of heart failure such as n-terminal pro-brain natriuretic peptide and low-density lipoprotein levels, inconsistently between diabetic and nondiabetic patients. Effective modulation of some heart failure-related outcomes with metformin treatment was related to its beneficial effects in ameliorating insulin resistance and blocking pro-inflammatory markers such as the aging-associated cytokine CCL11 (C-C motif chemokine ligand 11). Overall, although such beneficial effects were observed with metformin treatment, additional RCTs are necessary to improve our understanding on its modulatory effects on heart failure-related outcomes especially in diabetic patients.

Indexed as

Diabetes Mellitus, Type 2Heart FailureMetforminHumansHypoglycemic AgentsRandomized Controlled Trials as TopicHypoglycemic AgentsMetforminCardiac protectionDiabetesDyslipidemiaHeart failureHyperglycemiaMetformin

Identifiers

PMID32157481
OpenAlexW3011376422

What Socratic holds

Texttitle and abstract
Read underepoch 390

Registered trials

None linked

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.