Evidence map›Paper›PMID 18559720›Full record

Trial reportHypertension (Dallas, Tex. : 1979)2008

History of hypertension and eplerenone in patients with acute myocardial infarction complicated by heart failure.

Bertram Pitt, Ali Ahmed, Thomas E Love, Henry Krum, Jose Nicolau, José S Cardoso, Alexander Parkhomenko, Michael Aschermann, Ramon Corbalán, Henry Solomon and 2 more

Abstract readMulticenter StudyRandomized Controlled Trial
In one paragraph

Trial report in Hypertension (Dallas, Tex. : 1979), 2008. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 1 pooled it
2.8field-weighted citation impact, top 9% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 1 synthesis or guideline pooled it, 25 citations in OpenAlex.

  1. Pooled it
  2. Trial
  3. Review
  4. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

12 authors at 1 institution in 1 country.

Bertram PittUniversity of Michigan, 1500 E Medical Center Dr, 3910 Taubman Center, Ann Arbor, MI 48109-0366, USA. bpitt@med.umich.edu
Ali Ahmed
Thomas E Love
Henry Krum
Jose Nicolau
José S Cardoso
Alexander Parkhomenko
Michael Aschermann
Ramon Corbalán
Henry Solomon
Harry Shi
Faiez Zannad
Universidade de São Paulo · BR

Funding

The Impact on Diabetes on Left Ventricular RemodelingP50HL077100 · NHLBI · UNIVERSITY OF ALABAMA AT BIRMINGHAM · PI DELL'LTALIA, LOUIS · 2005 to 2009
$16.5M
Heart failure, chronic kidney disease, and renin-angiotensin system inhibitionR01HL085561 · NHLBI · UNIVERSITY OF ALABAMA AT BIRMINGHAM · PI AHMED, ALI · 2006 to 2009
$1.5M
NHLBI NIH HHS 5-R01-HL085561-02NHLBI NIH HHS P50 HL077100NHLBI NIH HHS P50-HL077100NHLBI NIH HHS R01 HL085561
6 · The paper itself

Abstract

In the Eplerenone Post-Acute Myocardial Infarction Heart Failure Efficacy and Survival Study (n=6632), eplerenone-associated reduction in all-cause mortality was significantly greater in those with a history of hypertension (Hx-HTN). There were 4007 patients with Hx-HTN (eplerenone: n=1983) and 2625 patients without Hx-HTN (eplerenone: n=1336). Propensity scores for eplerenone use, separately calculated for patients with and without Hx-HTN, were used to assemble matched cohorts of 1838 and 1176 pairs of patients. In patients with Hx-HTN, all-cause mortality occurred in 18% of patients treated with placebo (rate, 1430/10 000 person-years) and 14% of patients treated with eplerenone (rate, 1058/10 000 person-years) during 2350 and 2457 years of follow-up, respectively (hazard ratio [HR]: 0.71; 95% CI: 0.59 to 0.85; P<0.0001). Composite end point of cardiovascular hospitalization or cardiovascular mortality occurred in 33% of placebo-treated patients (3029/10 000 person-years) and 28% of eplerenone-treated patients (2438/10 000 person-years) with Hx-HTN (HR: 0.82; 95% CI: 0.72 to 0.94; P=0.003). In patients without Hx-HTN, eplerenone reduced heart failure hospitalization (HR: 73; 95% CI: 0.55 to 0.97; P=0.028) but had no effect on mortality (HR: 0.91; 95% CI: 0.72 to 1.15; P=0.435) or on the composite end point (HR: 0.91; 95% CI: 0.76 to 1.10; P=0.331). Eplerenone should, therefore, be prescribed to all of the post-acute myocardial infarction patients with reduced left ventricular ejection fraction and heart failure regardless of Hx-HTN.

Indexed as

AgedCause of DeathDose-Response Relationship, DrugDouble-Blind MethodDrug Administration ScheduleEplerenoneFemaleHeart FailureHumansHypertensionLogistic ModelsMaleMiddle AgedMineralocorticoid Receptor AntagonistsMultivariate AnalysisMyocardial InfarctionEplerenoneMineralocorticoid Receptor AntagonistsSpironolactone

Identifiers

PMID18559720
PMCPMC3782417
OpenAlexW2171729188

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.