Metformin and heart failure: never say never again

Expert Opin Pharmacother. 2012 Jan;13(1):1-8. doi: 10.1517/14656566.2012.638283.


Metformin represents the cornerstone of treatment for type 2 diabetes mellitus. Traditionally, heart failure (HF) was considered a contraindication to its use. However, more recent evidence has shown that this should no longer be the case. Indeed, studies have demonstrated that metformin may even reduce the risk of incident HF and mortality in diabetic patients, while improving up to 2-year survival rates in those with HF. In addition, it appears to exert cardioprotective actions. Although longer follow-up data and more explicit information about the situation in patients with very advanced HF are needed, the cardiac safety of metformin has profound clinical implications and may be anticipated to further encourage its widespread use.

Publication types

  • Editorial

MeSH terms

  • Cohort Studies
  • Diabetes Mellitus, Type 2 / drug therapy*
  • Diabetes Mellitus, Type 2 / epidemiology
  • Heart Failure / drug therapy*
  • Heart Failure / epidemiology
  • Humans
  • Hypoglycemic Agents / therapeutic use*
  • Metformin / therapeutic use*


  • Hypoglycemic Agents
  • Metformin