Evidence map›Paper›PMID 27413035›Full record

ArticleCirculation. Heart failure2016

Antihyperglycemic Medication Use Among Medicare Beneficiaries With Heart Failure, Diabetes Mellitus, and Chronic Kidney Disease.

Priyesh A Patel, Li Liang, Prateeti Khazanie, Bradley G Hammill, Gregg C Fonarow, Clyde W Yancy, Deepak L Bhatt, Lesley H Curtis, Adrian F Hernandez

Open access · bronzeAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Circulation. Heart failure, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed
3.0field-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

8 citing papers in PubMed, 23 citations in OpenAlex.

  1. Trial
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  8. Review
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

9 authors at 5 institutions in 1 country.

Priyesh A PatelFrom the Duke Clinical Research Institute, Durham, NC (P.A.P., L.L., P.K., B.G.H., L.H.C., A.F.H.); Ronald Reagan University of California Los Angeles Medical Center (G.C.F.); Division of Cardiology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL (C.W.Y.); Brigham and Women's Hospital Heart & Vascular Center, Harvard Medical School, Boston, MA (D.L.B.); and Duke University Medical Center, Durham, NC (A.F.H.). priyesh.patel@dm.duke.edu.
Li LiangFrom the Duke Clinical Research Institute, Durham, NC (P.A.P., L.L., P.K., B.G.H., L.H.C., A.F.H.); Ronald Reagan University of California Los Angeles Medical Center (G.C.F.); Division of Cardiology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL (C.W.Y.); Brigham and Women's Hospital Heart & Vascular Center, Harvard Medical School, Boston, MA (D.L.B.); and Duke University Medical Center, Durham, NC (A.F.H.).
Prateeti KhazanieFrom the Duke Clinical Research Institute, Durham, NC (P.A.P., L.L., P.K., B.G.H., L.H.C., A.F.H.); Ronald Reagan University of California Los Angeles Medical Center (G.C.F.); Division of Cardiology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL (C.W.Y.); Brigham and Women's Hospital Heart & Vascular Center, Harvard Medical School, Boston, MA (D.L.B.); and Duke University Medical Center, Durham, NC (A.F.H.).
Bradley G HammillFrom the Duke Clinical Research Institute, Durham, NC (P.A.P., L.L., P.K., B.G.H., L.H.C., A.F.H.); Ronald Reagan University of California Los Angeles Medical Center (G.C.F.); Division of Cardiology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL (C.W.Y.); Brigham and Women's Hospital Heart & Vascular Center, Harvard Medical School, Boston, MA (D.L.B.); and Duke University Medical Center, Durham, NC (A.F.H.).
Gregg C FonarowFrom the Duke Clinical Research Institute, Durham, NC (P.A.P., L.L., P.K., B.G.H., L.H.C., A.F.H.); Ronald Reagan University of California Los Angeles Medical Center (G.C.F.); Division of Cardiology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL (C.W.Y.); Brigham and Women's Hospital Heart & Vascular Center, Harvard Medical School, Boston, MA (D.L.B.); and Duke University Medical Center, Durham, NC (A.F.H.).
Clyde W YancyFrom the Duke Clinical Research Institute, Durham, NC (P.A.P., L.L., P.K., B.G.H., L.H.C., A.F.H.); Ronald Reagan University of California Los Angeles Medical Center (G.C.F.); Division of Cardiology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL (C.W.Y.); Brigham and Women's Hospital Heart & Vascular Center, Harvard Medical School, Boston, MA (D.L.B.); and Duke University Medical Center, Durham, NC (A.F.H.).
Deepak L BhattFrom the Duke Clinical Research Institute, Durham, NC (P.A.P., L.L., P.K., B.G.H., L.H.C., A.F.H.); Ronald Reagan University of California Los Angeles Medical Center (G.C.F.); Division of Cardiology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL (C.W.Y.); Brigham and Women's Hospital Heart & Vascular Center, Harvard Medical School, Boston, MA (D.L.B.); and Duke University Medical Center, Durham, NC (A.F.H.).
Lesley H CurtisFrom the Duke Clinical Research Institute, Durham, NC (P.A.P., L.L., P.K., B.G.H., L.H.C., A.F.H.); Ronald Reagan University of California Los Angeles Medical Center (G.C.F.); Division of Cardiology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL (C.W.Y.); Brigham and Women's Hospital Heart & Vascular Center, Harvard Medical School, Boston, MA (D.L.B.); and Duke University Medical Center, Durham, NC (A.F.H.).
Adrian F HernandezFrom the Duke Clinical Research Institute, Durham, NC (P.A.P., L.L., P.K., B.G.H., L.H.C., A.F.H.); Ronald Reagan University of California Los Angeles Medical Center (G.C.F.); Division of Cardiology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL (C.W.Y.); Brigham and Women's Hospital Heart & Vascular Center, Harvard Medical School, Boston, MA (D.L.B.); and Duke University Medical Center, Durham, NC (A.F.H.).
Ronald Reagan UCLA Medical Center · USHarvard University · USLos Angeles Medical Center · USBrigham and Women's Hospital · USUniversity of California, Los Angeles · US

Funding

MULTIDISCIPLINARY HEART &VASCULAR DISEASEST32HL007101 · NHLBI · DUKE UNIVERSITY · PI FREEDMAN, NEIL J. · 1985 to 2020
$9.8M
Using Data to Drive Change in National CV Care: The Duke CERTSU19HS021092 · AHRQ · DUKE UNIVERSITY · PI PETERSON, ERIC DAVID · 2011 to 2015
$4.2M
AHRQ HHS U19 HS021092NHLBI NIH HHS T32 HL007101
6 · The paper itself

Abstract

backgroundDiabetes mellitus, heart failure (HF), and chronic kidney disease are common comorbidities, but overall use and safety of antihyperglycemic medications (AHMs) among patients with these comorbidities are poorly understood. METHODS AND

resultsUsing Get With the Guidelines-Heart Failure and linked Medicare Part D data, we assessed AHM use within 90 days of hospital discharge among HF patients with diabetes mellitus discharged from Get With the Guidelines-Heart Failure hospitals between January 1, 2006, and October 1, 2011. We further summarized use by renal function and assessed renal contraindicated AHM use for patients with estimated glomerular filtration rate <30 mL/min/1.73m(2). Among 8791 patients meeting inclusion criteria, the median age was 77 (interquartile range 71-83), 62.3% were female, median body mass index was 29.7 (interquartile range 25.5-35.3), median hemoglobin A1c was 6.8 (interquartile range 6.2-7.8), and 34% had ejection fraction <40%. 74.9% of patients filled a prescription for an AHM, with insulin (39.5%), sulfonylureas (32.4%), and metformin (17%) being the most commonly used AHMs. Insulin use was higher and sulfonylurea/metformin use was lower among patients with lower renal function classes. Among 1512 patients with estimated glomerular filtration rate <30 mL/min/1.73m(2), 35.4% filled prescriptions for renal contraindicated AHMs per prescribing information, though there was a trend toward lower renal contraindicated AHM use over time (Cochran-Mantel-Haenszel row-mean score test P=0.048). Although use of other AHMs was low overall, thiazolidinediones were used in 6.6% of HF patients, and dipeptidyl peptidase-4 inhibitors were used in 5.1%, with trends for decreasing thiazolidinedione use and increased dipeptidyl peptidase-4 inhibitor use over time (P<0.001).

conclusionsTreatment of diabetes mellitus in patients with HF and chronic kidney disease is complex, and these patients are commonly treated with renal contraindicated AHMs, including over 6% receiving a thiazolidinedione, despite known concerns regarding HF. More research regarding safety and efficacy of various AHMs among HF patients is needed.

Indexed as

Hypoglycemic AgentsInsurance BenefitsMedicare Part DAgedAged, 80 and overComorbidityContraindicationsDiabetes MellitusDisease ProgressionDrug Utilization ReviewFemaleGlomerular Filtration RateGuideline AdherenceHeart FailureHospitalizationHumansHypoglycemic Agentschronic kidney disease diabetes mellitusglomerular filtration rateheart failureinsulin

Identifiers

PMID27413035
PMCPMC4948953
OpenAlexW2469145885

What OpenQuestion holds

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Registered trials

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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.