Metformin in Heart Failure Without Diabetes

Exclusion Criteria

• •Any oral or injectable hypoglycemic therapy (e.g. insulin, sulfonylureas)
• •Known allergy to metformin or major side effects to metformin treatment
• •Concomitant use of a carbonic anhydrase inhibitor (such as acetazolamide or topirafmate)
• •Heart Failure Hospitalizations in the past 3 months (primary diagnosis on admission is heart failure)
• •Acute myocardial infarction, unstable angina or revascularization with prior 3 months at the time of randomization
• •Planned coronary revascularization, heart surgery, CRT implantation or other intervention during the study period that would potentially affect the function of the heart
• •Significant, uncorrected primary cardiac valve disease, specifically severely stenotic or regurgitant mitral or aortic valves
• •Cardiac arrest or life threatening ventricular arrhythmias within the last 3 months (unless treated with an ICD)
• •Atrial fibrillation with poorly controlled ventricular rate at rest (\> 110 beats/min)
• •Hypertrophic or restrictive cardiomyopathy, infiltrative or storage myocardial disease, active myocarditis, or pericardial disease.
• •Planned major surgery within the study period
• •Female patients who are pregnant, nursing, or of childbearing potential while not practicing effective chemical contraceptive methods (i.e. oral, implanted, injectable, or transdermal contraceptive hormones; intrauterine device)
• •Current abuse of alcohol or drugs
• •Life-expectancy of less than 1 year due to co-existing morbid illness
• •Liver disease with ALT or AST \>3 times upper normal limit (it is possible to repeat this measurement once within a month)
• •Advanced lung disease such as COPD
• •Significant comorbidity or issue that makes the patient unsuitable for participation as judged by the investigator
• •Participation in another study involving long-term medical intervention (participation in device studies is allowed)