Effects of metformin treatment on the risk of acute myocardial infarction

Abstract Metformin, a cornerstone in the pharmacologic management of type 2 diabetes mellitus (T2DM), continues to be one of the most widely utilized antidiabetic agents globally. Beyond its primary role in glycemic control, metformin has demonstrated a variety of pleiotropic effects in both clinica...

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Main Authors: Chao-Chien Chang, Yu-Ching Chou, Tsan Yang, Jin-Yin Chang, Chien-An Sun
Format: Article
Language:English
Published: Nature Portfolio 2025-07-01
Series:Scientific Reports
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Online Access:https://doi.org/10.1038/s41598-025-13211-z
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author Chao-Chien Chang
Yu-Ching Chou
Tsan Yang
Jin-Yin Chang
Chien-An Sun
author_facet Chao-Chien Chang
Yu-Ching Chou
Tsan Yang
Jin-Yin Chang
Chien-An Sun
author_sort Chao-Chien Chang
collection DOAJ
description Abstract Metformin, a cornerstone in the pharmacologic management of type 2 diabetes mellitus (T2DM), continues to be one of the most widely utilized antidiabetic agents globally. Beyond its primary role in glycemic control, metformin has demonstrated a variety of pleiotropic effects in both clinical and experimental settings. Among these, its cardiovascular protective properties have attracted considerable attention. The purpose of this study was to investigate the benefits of metformin in acute myocardial infarction (AMI) prevention in patients with T2DM. This retrospective cohort study utilized data from Taiwan’s National Health Insurance Research Database, spanning the years 2000 to 2013. A total of 9186 patients with T2DM who were prescribed metformin were identified as the exposed group, while an equal number of patients with T2DM who had not received metformin served as the comparison (non-exposed) group. AMI was defined as the primary outcome of interest. To investigate the relationship between metformin use and AMI risk in patients with T2DM, hazard ratios (HRs) and corresponding 95% confidence intervals (CIs) were estimated using a Cox proportional hazards model. The analysis included 9186 metformin users and an equal number of non-users, we identified 282 and 339 AMI cases, respectively, for incidence rates of 3.36 and 4.15 per 1000 person years, respectively. Adjusted HR (95% CI) for metformin treatment and incident AMI was 0.76 (0.41–0.96). This negative association was consistently observed in both sexes [adjusted HR (95% CI) was 0.72 (0.56–0.97) for males adjusted HR (95% CI) was 0.87 (0.54–0.94) for females]. In summary, metformin treatment reduced the risk of AMI in patients with T2DM. These findings suggest that metformin may serve a dual role in both managing hyperglycemia and reducing cardiovascular risk.
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spelling doaj-art-1d8d304c40d54a2b883f6ee7476ddbd22025-08-20T04:01:52ZengNature PortfolioScientific Reports2045-23222025-07-011511610.1038/s41598-025-13211-zEffects of metformin treatment on the risk of acute myocardial infarctionChao-Chien Chang0Yu-Ching Chou1Tsan Yang2Jin-Yin Chang3Chien-An Sun4Division of Cardiology, Department of Internal Medicine, Cathay General HospitalSchool of Public Health, National Defense Medical CenterMaster Program in Transdisciplinary Long-Term Care, Meiho UniversityDepartment of Medical Research, Cathay General HospitalDepartment of Public Health, School of Medicine, Fu-Jen Catholic UniversityAbstract Metformin, a cornerstone in the pharmacologic management of type 2 diabetes mellitus (T2DM), continues to be one of the most widely utilized antidiabetic agents globally. Beyond its primary role in glycemic control, metformin has demonstrated a variety of pleiotropic effects in both clinical and experimental settings. Among these, its cardiovascular protective properties have attracted considerable attention. The purpose of this study was to investigate the benefits of metformin in acute myocardial infarction (AMI) prevention in patients with T2DM. This retrospective cohort study utilized data from Taiwan’s National Health Insurance Research Database, spanning the years 2000 to 2013. A total of 9186 patients with T2DM who were prescribed metformin were identified as the exposed group, while an equal number of patients with T2DM who had not received metformin served as the comparison (non-exposed) group. AMI was defined as the primary outcome of interest. To investigate the relationship between metformin use and AMI risk in patients with T2DM, hazard ratios (HRs) and corresponding 95% confidence intervals (CIs) were estimated using a Cox proportional hazards model. The analysis included 9186 metformin users and an equal number of non-users, we identified 282 and 339 AMI cases, respectively, for incidence rates of 3.36 and 4.15 per 1000 person years, respectively. Adjusted HR (95% CI) for metformin treatment and incident AMI was 0.76 (0.41–0.96). This negative association was consistently observed in both sexes [adjusted HR (95% CI) was 0.72 (0.56–0.97) for males adjusted HR (95% CI) was 0.87 (0.54–0.94) for females]. In summary, metformin treatment reduced the risk of AMI in patients with T2DM. These findings suggest that metformin may serve a dual role in both managing hyperglycemia and reducing cardiovascular risk.https://doi.org/10.1038/s41598-025-13211-zAcute myocardial infarctionCohort studyMetforminType 2 diabetes
spellingShingle Chao-Chien Chang
Yu-Ching Chou
Tsan Yang
Jin-Yin Chang
Chien-An Sun
Effects of metformin treatment on the risk of acute myocardial infarction
Scientific Reports
Acute myocardial infarction
Cohort study
Metformin
Type 2 diabetes
title Effects of metformin treatment on the risk of acute myocardial infarction
title_full Effects of metformin treatment on the risk of acute myocardial infarction
title_fullStr Effects of metformin treatment on the risk of acute myocardial infarction
title_full_unstemmed Effects of metformin treatment on the risk of acute myocardial infarction
title_short Effects of metformin treatment on the risk of acute myocardial infarction
title_sort effects of metformin treatment on the risk of acute myocardial infarction
topic Acute myocardial infarction
Cohort study
Metformin
Type 2 diabetes
url https://doi.org/10.1038/s41598-025-13211-z
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