Evidence map›Paper›PMID 28295907›Full record

Trial reportEuropean journal of heart failure2017

The effects of short-term omission of daily medication on the pathophysiology of heart failure.

Silviu Dovancescu, Pierpaolo Pellicori, Thato Mabote, Azam Torabi, Andrew L Clark, John G F Cleland

Open access · bronzeAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in European journal of heart failure, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 31 papers.

0numbers the graph read from it
0cells of the map it votes in
31citing papers in PubMed
6.1field-weighted citation impact, top 3% 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

31 citing papers in PubMed, 70 citations in OpenAlex.

  1. Article
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  12. Aiming at harmony. Comparing and contrasting International HFrEF Guidelines.European heart journal supplements : journal of the European Society of Cardiology · 2022
    Article
  13. Article
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  17. Review
  18. Range of adiposity and cardiorenal syndrome.World journal of diabetes · 2020
    Review
  19. Observational
  20. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

6 authors at 4 institutions in 4 countries.

Silviu DovancescuDepartment of Cardiology, Hull York Medical School, Hull and East Yorkshire Medical Research and Teaching Centre, Castle Hill Hospital, Cottingham, Kingston upon Hull, UK.
Pierpaolo PellicoriDepartment of Cardiology, Hull York Medical School, Hull and East Yorkshire Medical Research and Teaching Centre, Castle Hill Hospital, Cottingham, Kingston upon Hull, UK.
Thato MaboteDepartment of Cardiology, Hull York Medical School, Hull and East Yorkshire Medical Research and Teaching Centre, Castle Hill Hospital, Cottingham, Kingston upon Hull, UK.
Azam TorabiDepartment of Cardiology, Hull York Medical School, Hull and East Yorkshire Medical Research and Teaching Centre, Castle Hill Hospital, Cottingham, Kingston upon Hull, UK.
Andrew L ClarkDepartment of Cardiology, Hull York Medical School, Hull and East Yorkshire Medical Research and Teaching Centre, Castle Hill Hospital, Cottingham, Kingston upon Hull, UK.
John G F ClelandDepartment of Cardiology, Hull York Medical School, Hull and East Yorkshire Medical Research and Teaching Centre, Castle Hill Hospital, Cottingham, Kingston upon Hull, UK.
Castle Hill Hospital · GBHull York Medical School · GBLung Institute · USPhilips (Netherlands) · NL

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

aimsPharmacological therapies for heart failure (HF) aim to improve congestion, symptoms, and prognosis. Failing to take medication is a potential cause of worsening HF. Characterizing the effects of short-term medication omission could inform the development of better technologies and strategies to detect and interpret the reasons for worsening HF. We examined the effect of planned HF medication omission for 48 h on weight, echocardiograms, transthoracic bio-impedance, and plasma concentrations of NT-proBNP. METHODS AND

resultsOutpatients with stable HF and an LVEF <45% were assigned to take or omit their HF medication for 48 h in a randomized, crossover trial. Twenty patients (16 men, LVEF 32 ± 9%, median NT-proBNP 962 ng/L) were included. Compared with regular medication, omission led to an increase in NT-proBNP by 99% (from 962 to 1883 ng/L, P < 0.001), systolic blood pressure by 16% (from 131 to 152 mmHg, P < 0.001), and left atrial volume by 21% (from 69 to 80 mL, P = 0.001), and reductions in transthoracic bio-impedance by 10% (from 33 to 30 Σ, P = 0.001) and serum creatinine by 8% (from 135 to 118 µmol/L, P = 0.012). No significant changes in body weight, heart rate, or LVEF were observed.

conclusionsThe characteristic pattern of response to short-term medication omission is of increasing congestion but, in contrast to the pattern reported for disease progression, with a rise in blood pressure and improved renal function. In stable HF, weight is not a sensitive marker of short-term diuretic omission.

Indexed as

Adrenergic beta-AntagonistsAgedAngiotensin-Converting Enzyme InhibitorsBiomarkersBlood PressureBlood Pressure Monitoring, AmbulatoryCreatinineCross-Over StudiesDisease ProgressionDiureticsEchocardiographyElectric ImpedanceFemaleFollow-Up StudiesHeart FailureHeart RateAdrenergic beta-AntagonistsAngiotensin-Converting Enzyme InhibitorsBiomarkersCreatinineDiureticsMineralocorticoid Receptor AntagonistsNatriuretic Peptide, BrainPeptide Fragmentspro-brain natriuretic peptide (1-76)Cardiac ultrasoundCongestionHeart failureMedication omissionTelemonitoringTransthoracic bio-impedance

Identifiers

PMID28295907
PMCPMC5434940
OpenAlexW2603602454

What OpenQuestion holds

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LicenceCC BY-NC-ND
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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.