Evidence map›Paper›PMID 28626088›Full record

Trial reportCirculation2017

Secondary Prevention of Cardiovascular Disease in Patients With Type 2 Diabetes Mellitus: International Insights From the TECOS Trial (Trial Evaluating Cardiovascular Outcomes With Sitagliptin).

Neha J Pagidipati, Ann Marie Navar, Karen S Pieper, Jennifer B Green, M Angelyn Bethel, Paul W Armstrong, Robert G Josse, Darren K McGuire, Yuliya Lokhnygina, Jan H Cornel and 6 more

Registry-linked trialAbstract readMulticenter StudyRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Circulation, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT00790205 (TECOS), which is not on this map. Cited by 32 papers, 5 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
32citing papers in PubMed, 5 pooled it
–field-weighted citation impact
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.

NCT00790205 phase3completednot on this map

TECOS: A Randomized, Placebo Controlled Clinical Trial to Evaluate Cardiovascular Outcomes After Treatment With Sitagliptin in Patients With Type 2 Diabetes Mellitus and Inadequate Glycemic Control

TypeinterventionalSponsorMerck Sharp & Dohme LLCRan2008 to 2015Enrolled14,671ConditionsType 2 Diabetes MellitusArmsSitagliptin, Placebo
3 · Its place in the literature

Who cites it

32 citing papers in PubMed, 5 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Pooled it
  5. Pooled it
  6. Trial
  7. Trial
  8. Article
  9. Article
  10. Article
  11. Article
  12. Article
  13. Effect of sodium-glucose cotransporter 2 inhibitors on blood pressure in patients with type 2 diabetes and cardiovascular diseases.Hypertension research : official journal of the Japanese Society of Hypertension · 2024
    Article
  14. Observational
  15. Article
  16. Article
  17. Article
  18. Ferroptosis and Traditional Chinese Medicine for Type 2 Diabetes Mellitus.Diabetes, metabolic syndrome and obesity : targets and therapy · 2023
    Review
  19. Assessing costs of a hypertension program in primary care: evidence from the HEARTS program in Mexico.Revista panamericana de salud publica = Pan American journal of public health · 2022
    Article
  20. Review
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

16 authors.

Neha J PagidipatiFrom Duke Clinical Research Institute, Duke University School of Medicine, Durham, NC (N.J.P., A.M.N., K.S.P., J.B.G., Y.L., E.D.P.); Diabetes Trials Unit, Oxford Centre for Diabetes, Endocrinology and Metabolism, University of Oxford, United Kingdom (M.A.B., R.R.H.); Canadian VIGOUR Centre, University of Alberta, Edmonton, Canada (P.W.A.); St. Michael's Hospital, University of Toronto, Ontario, Canada (R.G.J.); Division of Cardiology, Department of Medicine, University of Texas Southwestern Medical Center, Dallas (D.K.M.); Noordwest Ziekenhuisgroep, Department of Cardiology, Alkmaar, the Netherlands (J.C.H.); Department of Cardiology, Oslo University Hospital, and University of Oslo, Norway (S.H.); University of Helsinki and Helsinki University Hospital, Finland (T.E.S.); University of Oulu, Center for Life Course Health Research, Finland (T.E.S.); and Department of Endocrinology and Metabolism, School of Medicine (Kastamonu), Hacettepe University, Ankara, Turkey (T.D.). neha.pagidipati@dm.duke.edu.
Ann Marie NavarFrom Duke Clinical Research Institute, Duke University School of Medicine, Durham, NC (N.J.P., A.M.N., K.S.P., J.B.G., Y.L., E.D.P.); Diabetes Trials Unit, Oxford Centre for Diabetes, Endocrinology and Metabolism, University of Oxford, United Kingdom (M.A.B., R.R.H.); Canadian VIGOUR Centre, University of Alberta, Edmonton, Canada (P.W.A.); St. Michael's Hospital, University of Toronto, Ontario, Canada (R.G.J.); Division of Cardiology, Department of Medicine, University of Texas Southwestern Medical Center, Dallas (D.K.M.); Noordwest Ziekenhuisgroep, Department of Cardiology, Alkmaar, the Netherlands (J.C.H.); Department of Cardiology, Oslo University Hospital, and University of Oslo, Norway (S.H.); University of Helsinki and Helsinki University Hospital, Finland (T.E.S.); University of Oulu, Center for Life Course Health Research, Finland (T.E.S.); and Department of Endocrinology and Metabolism, School of Medicine (Kastamonu), Hacettepe University, Ankara, Turkey (T.D.).
Karen S PieperFrom Duke Clinical Research Institute, Duke University School of Medicine, Durham, NC (N.J.P., A.M.N., K.S.P., J.B.G., Y.L., E.D.P.); Diabetes Trials Unit, Oxford Centre for Diabetes, Endocrinology and Metabolism, University of Oxford, United Kingdom (M.A.B., R.R.H.); Canadian VIGOUR Centre, University of Alberta, Edmonton, Canada (P.W.A.); St. Michael's Hospital, University of Toronto, Ontario, Canada (R.G.J.); Division of Cardiology, Department of Medicine, University of Texas Southwestern Medical Center, Dallas (D.K.M.); Noordwest Ziekenhuisgroep, Department of Cardiology, Alkmaar, the Netherlands (J.C.H.); Department of Cardiology, Oslo University Hospital, and University of Oslo, Norway (S.H.); University of Helsinki and Helsinki University Hospital, Finland (T.E.S.); University of Oulu, Center for Life Course Health Research, Finland (T.E.S.); and Department of Endocrinology and Metabolism, School of Medicine (Kastamonu), Hacettepe University, Ankara, Turkey (T.D.).
Jennifer B GreenFrom Duke Clinical Research Institute, Duke University School of Medicine, Durham, NC (N.J.P., A.M.N., K.S.P., J.B.G., Y.L., E.D.P.); Diabetes Trials Unit, Oxford Centre for Diabetes, Endocrinology and Metabolism, University of Oxford, United Kingdom (M.A.B., R.R.H.); Canadian VIGOUR Centre, University of Alberta, Edmonton, Canada (P.W.A.); St. Michael's Hospital, University of Toronto, Ontario, Canada (R.G.J.); Division of Cardiology, Department of Medicine, University of Texas Southwestern Medical Center, Dallas (D.K.M.); Noordwest Ziekenhuisgroep, Department of Cardiology, Alkmaar, the Netherlands (J.C.H.); Department of Cardiology, Oslo University Hospital, and University of Oslo, Norway (S.H.); University of Helsinki and Helsinki University Hospital, Finland (T.E.S.); University of Oulu, Center for Life Course Health Research, Finland (T.E.S.); and Department of Endocrinology and Metabolism, School of Medicine (Kastamonu), Hacettepe University, Ankara, Turkey (T.D.).
M Angelyn BethelFrom Duke Clinical Research Institute, Duke University School of Medicine, Durham, NC (N.J.P., A.M.N., K.S.P., J.B.G., Y.L., E.D.P.); Diabetes Trials Unit, Oxford Centre for Diabetes, Endocrinology and Metabolism, University of Oxford, United Kingdom (M.A.B., R.R.H.); Canadian VIGOUR Centre, University of Alberta, Edmonton, Canada (P.W.A.); St. Michael's Hospital, University of Toronto, Ontario, Canada (R.G.J.); Division of Cardiology, Department of Medicine, University of Texas Southwestern Medical Center, Dallas (D.K.M.); Noordwest Ziekenhuisgroep, Department of Cardiology, Alkmaar, the Netherlands (J.C.H.); Department of Cardiology, Oslo University Hospital, and University of Oslo, Norway (S.H.); University of Helsinki and Helsinki University Hospital, Finland (T.E.S.); University of Oulu, Center for Life Course Health Research, Finland (T.E.S.); and Department of Endocrinology and Metabolism, School of Medicine (Kastamonu), Hacettepe University, Ankara, Turkey (T.D.).
Paul W ArmstrongFrom Duke Clinical Research Institute, Duke University School of Medicine, Durham, NC (N.J.P., A.M.N., K.S.P., J.B.G., Y.L., E.D.P.); Diabetes Trials Unit, Oxford Centre for Diabetes, Endocrinology and Metabolism, University of Oxford, United Kingdom (M.A.B., R.R.H.); Canadian VIGOUR Centre, University of Alberta, Edmonton, Canada (P.W.A.); St. Michael's Hospital, University of Toronto, Ontario, Canada (R.G.J.); Division of Cardiology, Department of Medicine, University of Texas Southwestern Medical Center, Dallas (D.K.M.); Noordwest Ziekenhuisgroep, Department of Cardiology, Alkmaar, the Netherlands (J.C.H.); Department of Cardiology, Oslo University Hospital, and University of Oslo, Norway (S.H.); University of Helsinki and Helsinki University Hospital, Finland (T.E.S.); University of Oulu, Center for Life Course Health Research, Finland (T.E.S.); and Department of Endocrinology and Metabolism, School of Medicine (Kastamonu), Hacettepe University, Ankara, Turkey (T.D.).
Robert G JosseFrom Duke Clinical Research Institute, Duke University School of Medicine, Durham, NC (N.J.P., A.M.N., K.S.P., J.B.G., Y.L., E.D.P.); Diabetes Trials Unit, Oxford Centre for Diabetes, Endocrinology and Metabolism, University of Oxford, United Kingdom (M.A.B., R.R.H.); Canadian VIGOUR Centre, University of Alberta, Edmonton, Canada (P.W.A.); St. Michael's Hospital, University of Toronto, Ontario, Canada (R.G.J.); Division of Cardiology, Department of Medicine, University of Texas Southwestern Medical Center, Dallas (D.K.M.); Noordwest Ziekenhuisgroep, Department of Cardiology, Alkmaar, the Netherlands (J.C.H.); Department of Cardiology, Oslo University Hospital, and University of Oslo, Norway (S.H.); University of Helsinki and Helsinki University Hospital, Finland (T.E.S.); University of Oulu, Center for Life Course Health Research, Finland (T.E.S.); and Department of Endocrinology and Metabolism, School of Medicine (Kastamonu), Hacettepe University, Ankara, Turkey (T.D.).
Darren K McGuireFrom Duke Clinical Research Institute, Duke University School of Medicine, Durham, NC (N.J.P., A.M.N., K.S.P., J.B.G., Y.L., E.D.P.); Diabetes Trials Unit, Oxford Centre for Diabetes, Endocrinology and Metabolism, University of Oxford, United Kingdom (M.A.B., R.R.H.); Canadian VIGOUR Centre, University of Alberta, Edmonton, Canada (P.W.A.); St. Michael's Hospital, University of Toronto, Ontario, Canada (R.G.J.); Division of Cardiology, Department of Medicine, University of Texas Southwestern Medical Center, Dallas (D.K.M.); Noordwest Ziekenhuisgroep, Department of Cardiology, Alkmaar, the Netherlands (J.C.H.); Department of Cardiology, Oslo University Hospital, and University of Oslo, Norway (S.H.); University of Helsinki and Helsinki University Hospital, Finland (T.E.S.); University of Oulu, Center for Life Course Health Research, Finland (T.E.S.); and Department of Endocrinology and Metabolism, School of Medicine (Kastamonu), Hacettepe University, Ankara, Turkey (T.D.).
Yuliya LokhnyginaFrom Duke Clinical Research Institute, Duke University School of Medicine, Durham, NC (N.J.P., A.M.N., K.S.P., J.B.G., Y.L., E.D.P.); Diabetes Trials Unit, Oxford Centre for Diabetes, Endocrinology and Metabolism, University of Oxford, United Kingdom (M.A.B., R.R.H.); Canadian VIGOUR Centre, University of Alberta, Edmonton, Canada (P.W.A.); St. Michael's Hospital, University of Toronto, Ontario, Canada (R.G.J.); Division of Cardiology, Department of Medicine, University of Texas Southwestern Medical Center, Dallas (D.K.M.); Noordwest Ziekenhuisgroep, Department of Cardiology, Alkmaar, the Netherlands (J.C.H.); Department of Cardiology, Oslo University Hospital, and University of Oslo, Norway (S.H.); University of Helsinki and Helsinki University Hospital, Finland (T.E.S.); University of Oulu, Center for Life Course Health Research, Finland (T.E.S.); and Department of Endocrinology and Metabolism, School of Medicine (Kastamonu), Hacettepe University, Ankara, Turkey (T.D.).
Jan H CornelFrom Duke Clinical Research Institute, Duke University School of Medicine, Durham, NC (N.J.P., A.M.N., K.S.P., J.B.G., Y.L., E.D.P.); Diabetes Trials Unit, Oxford Centre for Diabetes, Endocrinology and Metabolism, University of Oxford, United Kingdom (M.A.B., R.R.H.); Canadian VIGOUR Centre, University of Alberta, Edmonton, Canada (P.W.A.); St. Michael's Hospital, University of Toronto, Ontario, Canada (R.G.J.); Division of Cardiology, Department of Medicine, University of Texas Southwestern Medical Center, Dallas (D.K.M.); Noordwest Ziekenhuisgroep, Department of Cardiology, Alkmaar, the Netherlands (J.C.H.); Department of Cardiology, Oslo University Hospital, and University of Oslo, Norway (S.H.); University of Helsinki and Helsinki University Hospital, Finland (T.E.S.); University of Oulu, Center for Life Course Health Research, Finland (T.E.S.); and Department of Endocrinology and Metabolism, School of Medicine (Kastamonu), Hacettepe University, Ankara, Turkey (T.D.).
Sigrun HalvorsenFrom Duke Clinical Research Institute, Duke University School of Medicine, Durham, NC (N.J.P., A.M.N., K.S.P., J.B.G., Y.L., E.D.P.); Diabetes Trials Unit, Oxford Centre for Diabetes, Endocrinology and Metabolism, University of Oxford, United Kingdom (M.A.B., R.R.H.); Canadian VIGOUR Centre, University of Alberta, Edmonton, Canada (P.W.A.); St. Michael's Hospital, University of Toronto, Ontario, Canada (R.G.J.); Division of Cardiology, Department of Medicine, University of Texas Southwestern Medical Center, Dallas (D.K.M.); Noordwest Ziekenhuisgroep, Department of Cardiology, Alkmaar, the Netherlands (J.C.H.); Department of Cardiology, Oslo University Hospital, and University of Oslo, Norway (S.H.); University of Helsinki and Helsinki University Hospital, Finland (T.E.S.); University of Oulu, Center for Life Course Health Research, Finland (T.E.S.); and Department of Endocrinology and Metabolism, School of Medicine (Kastamonu), Hacettepe University, Ankara, Turkey (T.D.).
Timo E StrandbergFrom Duke Clinical Research Institute, Duke University School of Medicine, Durham, NC (N.J.P., A.M.N., K.S.P., J.B.G., Y.L., E.D.P.); Diabetes Trials Unit, Oxford Centre for Diabetes, Endocrinology and Metabolism, University of Oxford, United Kingdom (M.A.B., R.R.H.); Canadian VIGOUR Centre, University of Alberta, Edmonton, Canada (P.W.A.); St. Michael's Hospital, University of Toronto, Ontario, Canada (R.G.J.); Division of Cardiology, Department of Medicine, University of Texas Southwestern Medical Center, Dallas (D.K.M.); Noordwest Ziekenhuisgroep, Department of Cardiology, Alkmaar, the Netherlands (J.C.H.); Department of Cardiology, Oslo University Hospital, and University of Oslo, Norway (S.H.); University of Helsinki and Helsinki University Hospital, Finland (T.E.S.); University of Oulu, Center for Life Course Health Research, Finland (T.E.S.); and Department of Endocrinology and Metabolism, School of Medicine (Kastamonu), Hacettepe University, Ankara, Turkey (T.D.).
Tuncay DelibasiFrom Duke Clinical Research Institute, Duke University School of Medicine, Durham, NC (N.J.P., A.M.N., K.S.P., J.B.G., Y.L., E.D.P.); Diabetes Trials Unit, Oxford Centre for Diabetes, Endocrinology and Metabolism, University of Oxford, United Kingdom (M.A.B., R.R.H.); Canadian VIGOUR Centre, University of Alberta, Edmonton, Canada (P.W.A.); St. Michael's Hospital, University of Toronto, Ontario, Canada (R.G.J.); Division of Cardiology, Department of Medicine, University of Texas Southwestern Medical Center, Dallas (D.K.M.); Noordwest Ziekenhuisgroep, Department of Cardiology, Alkmaar, the Netherlands (J.C.H.); Department of Cardiology, Oslo University Hospital, and University of Oslo, Norway (S.H.); University of Helsinki and Helsinki University Hospital, Finland (T.E.S.); University of Oulu, Center for Life Course Health Research, Finland (T.E.S.); and Department of Endocrinology and Metabolism, School of Medicine (Kastamonu), Hacettepe University, Ankara, Turkey (T.D.).
Rury R HolmanFrom Duke Clinical Research Institute, Duke University School of Medicine, Durham, NC (N.J.P., A.M.N., K.S.P., J.B.G., Y.L., E.D.P.); Diabetes Trials Unit, Oxford Centre for Diabetes, Endocrinology and Metabolism, University of Oxford, United Kingdom (M.A.B., R.R.H.); Canadian VIGOUR Centre, University of Alberta, Edmonton, Canada (P.W.A.); St. Michael's Hospital, University of Toronto, Ontario, Canada (R.G.J.); Division of Cardiology, Department of Medicine, University of Texas Southwestern Medical Center, Dallas (D.K.M.); Noordwest Ziekenhuisgroep, Department of Cardiology, Alkmaar, the Netherlands (J.C.H.); Department of Cardiology, Oslo University Hospital, and University of Oslo, Norway (S.H.); University of Helsinki and Helsinki University Hospital, Finland (T.E.S.); University of Oulu, Center for Life Course Health Research, Finland (T.E.S.); and Department of Endocrinology and Metabolism, School of Medicine (Kastamonu), Hacettepe University, Ankara, Turkey (T.D.).
Eric D PetersonFrom Duke Clinical Research Institute, Duke University School of Medicine, Durham, NC (N.J.P., A.M.N., K.S.P., J.B.G., Y.L., E.D.P.); Diabetes Trials Unit, Oxford Centre for Diabetes, Endocrinology and Metabolism, University of Oxford, United Kingdom (M.A.B., R.R.H.); Canadian VIGOUR Centre, University of Alberta, Edmonton, Canada (P.W.A.); St. Michael's Hospital, University of Toronto, Ontario, Canada (R.G.J.); Division of Cardiology, Department of Medicine, University of Texas Southwestern Medical Center, Dallas (D.K.M.); Noordwest Ziekenhuisgroep, Department of Cardiology, Alkmaar, the Netherlands (J.C.H.); Department of Cardiology, Oslo University Hospital, and University of Oslo, Norway (S.H.); University of Helsinki and Helsinki University Hospital, Finland (T.E.S.); University of Oulu, Center for Life Course Health Research, Finland (T.E.S.); and Department of Endocrinology and Metabolism, School of Medicine (Kastamonu), Hacettepe University, Ankara, Turkey (T.D.).
TECOS Study Group

Funding

Preventing Cardiovascular Disease through Improved Risk Prediction and CommunicationK01HL133416 · NHLBI · DUKE UNIVERSITY · PI NAVAR, ANN MARIE · 2016 to 2020
$707k
NHLBI NIH HHS K01 HL133416
6 · The paper itself

Abstract

backgroundIntensive risk factor modification significantly improves outcomes for patients with diabetes mellitus and cardiovascular disease. However, the degree to which secondary prevention treatment goals are achieved in international clinical practice is unknown.

methodsAttainment of 5 secondary prevention parameters-aspirin use, lipid control (low-density lipoprotein cholesterol <70 mg/dL or statin therapy), blood pressure control (<140 mm Hg systolic, <90 mm Hg diastolic), angiotensin-converting enzyme inhibitor or angiotensin receptor blocker use, and nonsmoking status-was evaluated among 13 616 patients from 38 countries with diabetes mellitus and known cardiovascular disease at entry into TECOS (Trial Evaluating Cardiovascular Outcomes With Sitagliptin). Logistic regression was used to evaluate the association between individual and regional factors and secondary prevention achievement at baseline. Cox proportional hazards regression analysis was used to determine the association between baseline secondary prevention achievement and cardiovascular death, myocardial infarction, or stroke.

resultsOverall, 29.9% of patients with diabetes mellitus and cardiovascular disease achieved all 5 secondary prevention parameters at baseline, although 71.8% achieved at least 4 parameters. North America had the highest proportion (41.2%), whereas Western Europe, Eastern Europe, and Latin America had proportions of ≈25%. Individually, blood pressure control (57.9%) had the lowest overall attainment, whereas nonsmoking status had the highest (89%). Over a median 3.0 years of follow-up, a higher baseline secondary prevention score was associated with improved outcomes in a step-wise graded relationship (adjusted hazard ratio, 0.60; 95% confidence interval, 0.47-0.77 for those patients achieving all 5 measures versus those achieving ≤2).

conclusionsIn an international trial population, significant opportunities exist to improve the quality of cardiovascular secondary prevention care among patients with diabetes mellitus and cardiovascular disease, which in turn could lead to reduced risk of downstream cardiovascular events. CLINICAL

trial registrationURL: http://www.clinicaltrials.gov. Unique identifier: NCT00790205.

Indexed as

AgedAngiotensin-Converting Enzyme InhibitorsAngiotensin Receptor AntagonistsAspirinBlood PressureCardiovascular DiseasesCholesterol, LDLDiabetes Mellitus, Type 2Double-Blind MethodFemaleFollow-Up StudiesHumansHypoglycemic AgentsLogistic ModelsMaleMiddle AgedAngiotensin-Converting Enzyme InhibitorsAngiotensin Receptor AntagonistsAspirinCholesterol, LDLHypoglycemic AgentsSitagliptin Phosphatecardiovascular diseasesdiabetes mellitussecondary prevention

Identifiers

PMID28626088
PMCPMC5614823

What OpenQuestion holds

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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.