caa a22 4500 606158502 CHVBK 20210128100619.0 cr unu---uuuuu 210128e20150601xx s 000 0 eng 10.1007/s10557-015-6601-x doi (NATIONALLICENCE)springer-10.1007/s10557-015-6601-x The Effect of Metformin Use on Left Ventricular Ejection Fraction and Mortality Post-Myocardial Infarction [Elektronische Daten] [Amjad Abualsuod, Joshua Rutland, Thomas Watts, Summit Pandat, Robert Delongchamp, Jawahar Mehta] Background: Animal studies showed that the use of metformin after myocardial infarction (MI) resulted in a protective effect on cardiac myocytes. In this study, we examined the effect of metformin in patients with diabetes mellitus (DM) on left ventricular ejection fraction (LVEF) and post-MI mortality. Methods: We reviewed charts of patients with MI admitted to the UAMS medical center. Baseline characteristics and 12-month follow up data were collected. Patients were classified into three groups: Control group- no DM (n = 464), Metformin group- DM + MI (n = 88) and No-Metformin group- DM + MI (n = 168). First, we compared Metformin and No-Metformin groups to the Control group. Second, we performed propensity-score matching in patients with DM, and compared Metformin to No-Metformin groups. Results: All-cause 30-day and 12-month mortality was significantly higher in the No-Metformin group compared to controls (13.5 vs 9.3% p = 0.03 at 30days, 23.7 vs 15.9% p = 0.03 at 12 months). However, all-cause 30-day and 12-month mortality were similar in the Controls and Metformin group (9.3 vs 6.8% p = 0.93 at 30days, 15.9 vs 11.4% p = 0.97 at 12 months). Mean LVEF on presentation (45% in the three groups) and at follow up (47.84, 46.38 and 43.62% in Control, Metformin, and No-Metformin groups, respectively) were not statistically different. There were no significant differences in regard to re-hospitalization, re-intervention, new stroke, CHF development, new MI, or identifiable arrhythmias. Metformin was an independent predictor of lower 30-day and 12-month all-cause mortality in patients with DM (HR 0.25, p = 0.02 and HR 0.32, p = 0.01, respectively). In the matched analysis, 30-day all-cause mortality was significantly higher in the No-Metformin compared to the Metformin group (21.1 vs 8.8%, p = 0.05). However the difference in 12-month all-cause mortality did not reach statistical significance (24.6 vs 15.8%, p = 0.15). Conclusion: This proof-of-concept study shows that use of metformin in patients with DM is associated with lower 30-day all-cause mortality and tendency for a lower 12-month all-cause mortality following MI without discernible improvement in LVEF. Springer Science+Business Media New York, 2015 Myocardial infarction nationallicence Mortality nationallicence Left ventricular ejection fraction nationallicence Metformin nationallicence Abualsuod Amjad Division of General Internal Medicine, University of Arkansas for Medical Sciences, 72205, Little Rock, AR, USA aut Rutland Joshua Division of General Internal Medicine, University of Arkansas for Medical Sciences, 72205, Little Rock, AR, USA aut Watts Thomas Division of General Internal Medicine, University of Arkansas for Medical Sciences, 72205, Little Rock, AR, USA aut Pandat Summit Division of General Internal Medicine, University of Arkansas for Medical Sciences, 72205, Little Rock, AR, USA aut Delongchamp Robert Department of Epidemiology, College of Public Health, University of Arkansas for Medical Sciences, 72205, Little Rock, AR, USA aut Mehta Jawahar Division of General Internal Medicine, University of Arkansas for Medical Sciences, 72205, Little Rock, AR, USA aut Cardiovascular Drugs and Therapy Springer US; http://www.springer-ny.com 29/3(2015-06-01), 265-275 0920-3206 29:3<265 2015 29 10557 https://doi.org/10.1007/s10557-015-6601-x text/html Onlinezugriff via DOI BK010053 XK010053 XK010000 Metadata rights reserved Springer special CC-BY-NC licence nationallicence 1 research-article jats NATIONALLICENCE NATIONALLICENCE NL-springer NATIONALLICENCE 856 40 https://doi.org/10.1007/s10557-015-6601-x text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Abualsuod Amjad Division of General Internal Medicine, University of Arkansas for Medical Sciences, 72205, Little Rock, AR, USA aut NATIONALLICENCE 700 1- Rutland Joshua Division of General Internal Medicine, University of Arkansas for Medical Sciences, 72205, Little Rock, AR, USA aut NATIONALLICENCE 700 1- Watts Thomas Division of General Internal Medicine, University of Arkansas for Medical Sciences, 72205, Little Rock, AR, USA aut NATIONALLICENCE 700 1- Pandat Summit Division of General Internal Medicine, University of Arkansas for Medical Sciences, 72205, Little Rock, AR, USA aut NATIONALLICENCE 700 1- Delongchamp Robert Department of Epidemiology, College of Public Health, University of Arkansas for Medical Sciences, 72205, Little Rock, AR, USA aut NATIONALLICENCE 700 1- Mehta Jawahar Division of General Internal Medicine, University of Arkansas for Medical Sciences, 72205, Little Rock, AR, USA aut NATIONALLICENCE 773 0- Cardiovascular Drugs and Therapy Springer US; http://www.springer-ny.com 29/3(2015-06-01), 265-275 0920-3206 29:3<265 2015 29 10557