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The prescribing information for metformin lists congestive heart failure (CHF) as a contraindication to its use, because of concerns that CHF patients might be at increased risk for metformin-induced lactic acidosis. However, little evidence supports this position.
In this study, researchers analyzed data from the provincial healthcare database in Saskatchewan, Canada. They identified 1883 diabetic patients with incident CHF who used a sulfonylurea alone (42%), metformin alone (11%), or both drugs (47%) during a 6-year interval. In analyses adjusted for potentially confounding variables, all-cause mortality rates during the year following the diagnosis of CHF were significantly lower in the metformin group (hazard ratio, 0.66) and the combin…