Bromage DI, Godec TR, Pujades-Rodriguez M, et al. - Using a large cohort of patients in England, researchers compared patient outcomes by metformin status at the time of admission for fatal and non-fatal acute myocardial infarction (AMI). They combined data from primary care, hospital admissions, and death registry from 4.7 million residents in England, as part of the CALIBER resource. A composite of AMI requiring hospitalization, stroke, and cardiovascular mortality was assessed as the primary endpoint. Heart failure hospitalization and all-cause mortality were assessed as secondary endpoints. Findings revealed an increased risk of cardiovascular disease and death in relation to metformin use at the time of first AMI in patients with type 2 diabetes. The authors noted that its use after AMI might offer benefits; however, further study is needed, particularly considering the mounting evidence that sodium-glucose co-transporter-2 inhibitors may offer cardioprotection.