Evidence map›Paper›PMID 24727254›Full record

Trial reportJournal of the American College of Cardiology2014

Fibroblast growth factor-23, cardiovascular prognosis, and benefit of angiotensin-converting enzyme inhibition in stable ischemic heart disease.

Jacob A Udell, David A Morrow, Petr Jarolim, Sarah Sloan, Elaine B Hoffman, Thomas F O'Donnell, Amit N Vora, Torbjørn Omland, Scott D Solomon, Marc A Pfeffer and 2 more

Registry-linked trialOpen access · greenAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Journal of the American College of Cardiology, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT00000558 (Prevention of Events With Angiotensin-Converting Enzyme Inhibitor Therapy), which is not on this map. Cited by 47 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
47citing papers in PubMed, 1 pooled it
5.6field-weighted citation impact, top 4% 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.

NCT00000558 phase3completednot on this map

Prevention of Events With Angiotensin-Converting Enzyme Inhibitor Therapy (PEACE)

TypeinterventionalSponsorNational Heart, Lung, and Blood Institute (NHLBI)Ran1995 to 2005ConditionsCardiovascular Diseases, Coronary Disease, Heart Diseases, Myocardial InfarctionArmsangiotensin-converting enzyme inhibitors
3 · Its place in the literature

Who cites it

47 citing papers in PubMed, 1 synthesis or guideline pooled it, 95 citations in OpenAlex.

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  11. Vitamin D-Parathyroid Hormone-Fibroblast Growth Factor 23 Axis and Cardiac Remodeling.American journal of cardiovascular drugs : drugs, devices, and other interventions · 2025
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors at 5 institutions in 4 countries.

Jacob A UdellWomen's College Research Institute and Division of Cardiology, Department of Medicine, Women's College Hospital, University of Toronto, Toronto, Ontario, Canada.
David A MorrowTIMI Study Group, Cardiovascular Division, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts.
Petr JarolimDepartment of Pathology, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts.
Sarah SloanTIMI Study Group, Cardiovascular Division, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts.
Elaine B HoffmanTIMI Study Group, Cardiovascular Division, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts.
Thomas F O'DonnellDepartment of Surgery, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts.
Amit N VoraDuke Clinical Research Institute, Durham, North Carolina.
Torbjørn OmlandDepartment of Cardiology, Division of Medicine, Akershus University Hospital, and Center for Heart Failure Research and KG Jebsen Cardiac Research Centre, University of Oslo, Oslo, Norway.
Scott D SolomonCardiovascular Division, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts.
Marc A PfefferCardiovascular Division, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts.
Eugene BraunwaldTIMI Study Group, Cardiovascular Division, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts.
Marc S SabatineTIMI Study Group, Cardiovascular Division, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts. Electronic address: msabatine@partners.org.
Brigham and Women's Hospital · USDurham University · GBHarvard University · USUniversity of Oslo · NOUniversity of Toronto · CA

Funding

PREVENTION OF EVENTS WITH ACE INHIBITORS--CLINICAL TRIAL-268965149N01HC065149 · HC · GEORGE WASHINGTON UNIVERSITY · 1996 to 2003
$3.1M
Novel Biomarkers to Identify Vulnerable Patients with Coronary Artery DiseaseR01HL094390 · NHLBI · BRIGHAM AND WOMEN'S HOSPITAL · PI SABATINE, MARC S · 2009 to 2012
$1.3M
CIHRNHLBI NIH HHS N01 HC065149NHLBI NIH HHS R01 HL094390NHLBI NIH HHS R01HL094390
6 · The paper itself

Abstract

objectivesThis study sought to test 2 hypotheses: 1) fibroblast growth factor (FGF)-23 identifies patients with stable ischemic heart disease (SIHD) at high risk of cardiovascular events independent of clinical factors, renal function, and established cardiovascular biomarkers; and 2) FGF-23 identifies patients who derive greater clinical benefit from angiotensin-converting enzyme inhibitor therapy.

backgroundFGF-23 is an endocrine regulator of mineral metabolism and markedly elevated levels are associated with cardiovascular events in patients with chronic kidney disease. Data in patients with SIHD are more sparse.

methodsFGF-23 levels were measured in 3,627 patients with SIHD randomly assigned to trandolapril or placebo within the PEACE (Prevention of Events With Angiotensin-Converting Enzyme) trial and followed up for a median of 5.1 years.

resultsAfter adjustment for clinical risk predictors, left ventricular ejection fraction, markers of renal function, and established cardiovascular biomarkers, FGF-23 concentration was independently associated with an increased risk of cardiovascular death or heart failure among patients allocated to placebo (quartile 4 hazard ratio: 1.73; 95% confidence interval, 1.09 to 2.74; p = 0.02) and significantly improved metrics of discrimination. Furthermore, among patients in the top quartile of FGF-23 levels, trandolapril significantly reduced cardiovascular death or incident heart failure (hazard ratio: 0.45; 95% confidence interval: 0.28 to 0.72), whereas there was no clinical benefit in the remaining patients (hazard ratio: 1.07; 95% confidence interval: 0.75 to 1.52; p interaction = 0.0039). This interaction was independent of and additive to stratification based on renal function.

conclusionsElevated levels of FGF-23 are associated with cardiovascular death and incident heart failure in patients with SIHD and identify patients who derive significant clinical benefit from angiotensin-converting enzyme inhibitor therapy regardless of renal function. (Prevention of Events With Angiotensin-Converting Enzyme Inhibitor Therapy [PEACE]: NCT00000558).

Indexed as

AgedAngiotensin-Converting Enzyme InhibitorsBiomarkersCardiovascular DiseasesFemaleFibroblast Growth Factor-23Fibroblast Growth FactorsHumansIndolesMaleMiddle AgedMyocardial IschemiaPrognosisRiskAngiotensin-Converting Enzyme InhibitorsBiomarkersFGF23 protein, humanFibroblast Growth Factor-23Fibroblast Growth FactorsIndolestrandolaprilangiotensin-converting enzyme inhibitorsbiomarkerscoronary artery diseasefibroblast growth factor-23kidney

Identifiers

PMID24727254
PMCPMC4213068
OpenAlexW2041447143

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Registered trials

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.