Trial reportBMC medical research methodology2012
Comparing marginal structural models to standard methods for estimating treatment effects of antihypertensive combination therapy.
Trial report in BMC medical research methodology, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT00133692 (INternational VErapamil SR Trandolapril STudy), which is not on this map. Cited by 13 papers, 1 of them a synthesis that pooled it.
What it found
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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.
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.
INternational VErapamil SR Trandolapril STudy
Who cites it
13 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Application of marginal structural models in pharmacoepidemiologic studies: a systematic review.Pharmacoepidemiology and drug safety · 2014Pooled it
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- Blood pressure thresholds for the administration of balanced crystalloids and the effect on intra-operative hypotension: A proof-of-concept causal inference analysis featuring idealised dynamic treatment regimens.European journal of anaesthesiology · 2026Observational
- Association of low-dose ketamine with hallucinations in critically ill patients: a target trial emulation.Intensive care medicine · 2025Article
- A target trial emulation of dexmedetomidine to treat agitation in the intensive care unit.Critical care science · 2025Article
- The effect of time-varying capacity utilization on 14-day in-hospital mortality: a retrospective longitudinal study in Swiss general hospitals.BMC health services research · 2022Observational
- Association of Preeclampsia With Incident Stroke in Later Life Among Women in the Framingham Heart Study.JAMA network open · 2021Observational
- Comparison of statistical approaches dealing with time-dependent confounding in drug effectiveness studies.Statistical methods in medical research · 2018Article
- Does being physically active prevent future disability in older people? Attenuated effects when taking time-dependent confounders into account.BMC geriatrics · 2017Observational
- Estimating the effects of second-line therapy for type 2 diabetes mellitus: retrospective cohort study.BMJ open diabetes research & care · 2017Article
- What's new in the quantification of causal effects from longitudinal cohort studies: a brief introduction to marginal structural models for intensivists.Intensive care medicine · 2016Article
- Mechanisms and mediation in survival analysis: towards an integrated analytical framework.BMC medical research methodology · 2016Article
- Deferasirox therapy is associated with reduced mortality risk in a medicare population with myelodysplastic syndromes.Journal of comparative effectiveness research · 2015Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors.
Funding
Abstract
backgroundDue to time-dependent confounding by blood pressure and differential loss to follow-up, it is difficult to estimate the effectiveness of aggressive versus conventional antihypertensive combination therapies in non-randomized comparisons.
methodsWe utilized data from 22,576 hypertensive coronary artery disease patients, prospectively enrolled in the INternational VErapamil-Trandolapril STudy (INVEST). Our post-hoc analyses did not consider the randomized treatment strategies, but instead defined exposure time-dependently as aggressive treatment (≥3 concomitantly used antihypertensive medications) versus conventional treatment (≤2 concomitantly used antihypertensive medications). Study outcome was defined as time to first serious cardiovascular event (non-fatal myocardial infarction, non-fatal stroke, or all-cause death). We compared hazard ratio (HR) estimates for aggressive vs. conventional treatment from a Marginal Structural Cox Model (MSCM) to estimates from a standard Cox model. Both models included exposure to antihypertensive treatment at each follow-up visit, demographics, and baseline cardiovascular risk factors, including blood pressure. The MSCM further adjusted for systolic blood pressure at each follow-up visit, through inverse probability of treatment weights.
results2,269 (10.1%) patients experienced a cardiovascular event over a total follow-up of 60,939 person-years. The HR for aggressive treatment estimated by the standard Cox model was 0.96 (95% confidence interval 0.87-1.07). The equivalent MSCM, which was able to account for changes in systolic blood pressure during follow-up, estimated a HR of 0.81 (95% CI 0.71-0.92).
conclusionsUsing a MSCM, aggressive treatment was associated with a lower risk for serious cardiovascular outcomes compared to conventional treatment. In contrast, a standard Cox model estimated similar risks for aggressive and conventional treatments.
trial registrationClinicaltrials.gov Identifier: NCT00133692.
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