title: [Use of metformin in diabetic patients with cardiac disease: benefit-risk balance].
abstract: 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.
authors.affiliation: Université de Liège Service de diabétologie, nutrition et maladies métaboliques et Unité de pharmacologie clinique, Département de médecine, CHU Sart Tilman, 4000 Liège, Belgique.
authors.forename: A J
authors.initials: AJ
authors.lastname: Scheen
authors.forename: N
authors.initials: N
authors.lastname: Paquot
mesh_terms: D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000188:drug therapy*; D006331:Heart Diseases / Q000150:complications*; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D008687:Metformin / Q000627:therapeutic use*; D018570:Risk Assessment
chemical_list: D007004:Hypoglycemic Agents; D008687:Metformin