Use of metformin in diabetic patients with cardiac disease: benefit-risk balance
Scheen, A.J.; Paquot, N.
Revue Medicale Suisse 9(395): 1527-1533
2013
ISSN/ISBN: 1660-9379 PMID: 24024423 Document Number: 667096
Metformin is unanimously considered as the first-line glucose-lowering agent in type 2 diabetes. Theoretically, however, it cannot be prescribed in a large proportion of patients because of the presence of numerous contraindications corresponding to situations that may increase the risk of lactic acidosis. Recent data suggest that type 2 diabetes patients who are considered as being "at risk" because of the presence of cardiac disease still take benefit from metformin therapy, with a reduction of morbidity and mortality compared with other glucose-lowering agents. The present review analyzes the benefit-risk balance of metformin therapy in special populations, namely patients with stable coronary artery disease, acute coronary syndrome or myocardial infarction, or congestive heart failure.