BACKGROUND Metformin is among the most frequently prescribed antidiabetic drugs worldwide and remains the first-line therapy for type 2 diabetes due to its well-established glucose-lowering efficacy and favorable safety profile. SUMMARY Studies over the past decades show that metformin also exerts many other beneficial effects independent of its glucose-lowering effect both in experimental models and human subjects. Among them, the most notable is its cardiovascular protective effect. In this review, we discuss the latest cutting-edge research findings on metformin's cardiovascular protection from both preclinical studies and randomized clinical trials. We focus on describing novel basic research discoveries reported in influential journals and discussing their implications in the context of latest clinical trial findings related to common cardiovascular and metabolic disorders, including atherosclerosis and dyslipidemia, myocardial injury, and heart failure. KEY MESSAGES While substantial preclinical and clinical evidence suggests metformin as a potential cardiovascular protectant, large-scale randomized controlled trials are warranted to establish its clinical efficacy in treating patients with atherosclerotic cardiovascular disease and heart failure.

中文翻译：

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二甲双胍对心血管的保护：基础和临床研究的最新进展。

背景二甲双胍是全世界最常用的抗糖尿病药物之一，并且由于其公认的降糖功效和良好的安全性，仍然是 2 型糖尿病的一线治疗药物。摘要过去几十年的研究表明，二甲双胍在实验模型和人类受试者中还发挥许多其他与其降血糖作用无关的有益作用。其中，最引人注目的是它的心血管保护作用。在这篇综述中，我们讨论了临床前研究和随机临床试验中关于二甲双胍心血管保护作用的最新前沿研究结果。我们专注于描述有影响力的期刊中报道的新颖的基础研究发现，并讨论它们在与常见心血管和代谢疾病相关的最新临床试验结果的背景下的影响，包括动脉粥样硬化和血脂异常、心肌损伤和心力衰竭。关键信息 虽然大量临床前和临床证据表明二甲双胍作为潜在的心血管保护剂，但仍需要大规模随机对照试验来确定其治疗动脉粥样硬化性心血管疾病和心力衰竭患者的临床疗效。