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As summarized in Table 4, preclinical and clinical studies support cardioprotective effects of metformin across diverse cardiac conditions, but large, rigorously designed trials are needed to define its role beyond metabolic indications

Ongoing & Emerging Research Heart Failure with Preserved Ejection Fraction Status: Phase 3 Ongoing Focus: HFpEF outcomes in obese patients Timeline: Results expected 2025-2026 NASH/MASH Status: Phase 3 Ongoing Focus: Hepatic steatosis and fibrosis improvement Timeline: Multiple trials in progress Obstructive Sleep Apnea Status: Phase 3 Ongoing (SURMOUNT-OSA) Focus: OSA severity reduction with weight loss Timeline: Results expected 2024 Pediatric Obesity Status: Phase 3 Ongoing Focus: Weight management in adolescents (12 years) Timeline: Early-phase research Research Resources How to Find More Trials 1

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achieves higher levels of circulating glutathione

Sustainable metabolic health requires ongoing commitment beyond initial weight loss phases