Evidence map›Paper›PMID 28637881›Full record

Trial reportCirculation2017

Physical Activity and Prognosis in the TOPCAT Trial (Treatment of Preserved Cardiac Function Heart Failure With an Aldosterone Antagonist).

Sheila M Hegde, Brian Claggett, Amil M Shah, Eldrin F Lewis, Inder Anand, Sanjiv J Shah, Nancy K Sweitzer, James C Fang, Bertram Pitt, Marc A Pfeffer and 1 more

3 registry-linked trialsAbstract 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 3 registered trials, which are not on this map. Cited by 55 papers, 5 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
55citing 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.

NCT00094302 phase3completednot on this map

Treatment of Preserved Cardiac Function Heart Failure With an Aldosterone Antagonist (TOPCAT)

TypeinterventionalSponsorCarelon ResearchRan2006 to 2013Enrolled3,445ConditionsCardiovascular Diseases, Heart Diseases, Heart Failure, CongestiveArmsSpironolactone, Placebo
NCT04425785 nacompletednot on this mapstarted 2019, after this paper: background citation

Physical Exercise and Mental Wellbeing Rehabilitation for Acute Stress-induced Takotsubo Cardiomyopathy: The PLEASE Study

TypeinterventionalSponsorUniversity of AberdeenRan2019 to 2023Enrolled76ConditionsTakotsubo CardiomyopathyArmsPhysical Exercise Program, Cognitive Behavioural Therapy
NCT04467411 active not recruitingnot on this mapstarted 2020, after this paper: background citation

Randomised Controlled Study of Physical Exercise Intervention in Breast Cancer Patients at Risk of Anthracycline-induced Cardiomyopathy:The EMBRACE Study

TypeobservationalSponsorUniversity of AberdeenRan2020 to 2030Enrolled70ConditionsBreast Cancer
3 · Its place in the literature

Who cites it

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

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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

11 authors.

Sheila M HegdeFrom Cardiovascular Division, Brigham and Women's Hospital, Boston, MA (S.M.H., B.C., A.M.S., E.F.L., M.A.P., S.D.S.); Department of Cardiology, VA Medical Center and Division of Cardiovascular Medicine, University of Minnesota, Minneapolis (I.A.); Cardiology Division, Northwestern University, Chicago, IL (S.J.S.); Division of Cardiology, University of Arizona, Tucson (N.K.S.); Division of Cardiovascular Medicine, University of Utah, Salt Lake City (J.D.F.); and Cardiovascular Medicine Division, University of Michigan School of Medicine, Ann Arbor (B.P.).
Brian ClaggettFrom Cardiovascular Division, Brigham and Women's Hospital, Boston, MA (S.M.H., B.C., A.M.S., E.F.L., M.A.P., S.D.S.); Department of Cardiology, VA Medical Center and Division of Cardiovascular Medicine, University of Minnesota, Minneapolis (I.A.); Cardiology Division, Northwestern University, Chicago, IL (S.J.S.); Division of Cardiology, University of Arizona, Tucson (N.K.S.); Division of Cardiovascular Medicine, University of Utah, Salt Lake City (J.D.F.); and Cardiovascular Medicine Division, University of Michigan School of Medicine, Ann Arbor (B.P.).
Amil M ShahFrom Cardiovascular Division, Brigham and Women's Hospital, Boston, MA (S.M.H., B.C., A.M.S., E.F.L., M.A.P., S.D.S.); Department of Cardiology, VA Medical Center and Division of Cardiovascular Medicine, University of Minnesota, Minneapolis (I.A.); Cardiology Division, Northwestern University, Chicago, IL (S.J.S.); Division of Cardiology, University of Arizona, Tucson (N.K.S.); Division of Cardiovascular Medicine, University of Utah, Salt Lake City (J.D.F.); and Cardiovascular Medicine Division, University of Michigan School of Medicine, Ann Arbor (B.P.).
Eldrin F LewisFrom Cardiovascular Division, Brigham and Women's Hospital, Boston, MA (S.M.H., B.C., A.M.S., E.F.L., M.A.P., S.D.S.); Department of Cardiology, VA Medical Center and Division of Cardiovascular Medicine, University of Minnesota, Minneapolis (I.A.); Cardiology Division, Northwestern University, Chicago, IL (S.J.S.); Division of Cardiology, University of Arizona, Tucson (N.K.S.); Division of Cardiovascular Medicine, University of Utah, Salt Lake City (J.D.F.); and Cardiovascular Medicine Division, University of Michigan School of Medicine, Ann Arbor (B.P.).
Inder AnandFrom Cardiovascular Division, Brigham and Women's Hospital, Boston, MA (S.M.H., B.C., A.M.S., E.F.L., M.A.P., S.D.S.); Department of Cardiology, VA Medical Center and Division of Cardiovascular Medicine, University of Minnesota, Minneapolis (I.A.); Cardiology Division, Northwestern University, Chicago, IL (S.J.S.); Division of Cardiology, University of Arizona, Tucson (N.K.S.); Division of Cardiovascular Medicine, University of Utah, Salt Lake City (J.D.F.); and Cardiovascular Medicine Division, University of Michigan School of Medicine, Ann Arbor (B.P.).
Sanjiv J ShahFrom Cardiovascular Division, Brigham and Women's Hospital, Boston, MA (S.M.H., B.C., A.M.S., E.F.L., M.A.P., S.D.S.); Department of Cardiology, VA Medical Center and Division of Cardiovascular Medicine, University of Minnesota, Minneapolis (I.A.); Cardiology Division, Northwestern University, Chicago, IL (S.J.S.); Division of Cardiology, University of Arizona, Tucson (N.K.S.); Division of Cardiovascular Medicine, University of Utah, Salt Lake City (J.D.F.); and Cardiovascular Medicine Division, University of Michigan School of Medicine, Ann Arbor (B.P.).
Nancy K SweitzerFrom Cardiovascular Division, Brigham and Women's Hospital, Boston, MA (S.M.H., B.C., A.M.S., E.F.L., M.A.P., S.D.S.); Department of Cardiology, VA Medical Center and Division of Cardiovascular Medicine, University of Minnesota, Minneapolis (I.A.); Cardiology Division, Northwestern University, Chicago, IL (S.J.S.); Division of Cardiology, University of Arizona, Tucson (N.K.S.); Division of Cardiovascular Medicine, University of Utah, Salt Lake City (J.D.F.); and Cardiovascular Medicine Division, University of Michigan School of Medicine, Ann Arbor (B.P.).
James C FangFrom Cardiovascular Division, Brigham and Women's Hospital, Boston, MA (S.M.H., B.C., A.M.S., E.F.L., M.A.P., S.D.S.); Department of Cardiology, VA Medical Center and Division of Cardiovascular Medicine, University of Minnesota, Minneapolis (I.A.); Cardiology Division, Northwestern University, Chicago, IL (S.J.S.); Division of Cardiology, University of Arizona, Tucson (N.K.S.); Division of Cardiovascular Medicine, University of Utah, Salt Lake City (J.D.F.); and Cardiovascular Medicine Division, University of Michigan School of Medicine, Ann Arbor (B.P.).
Bertram PittFrom Cardiovascular Division, Brigham and Women's Hospital, Boston, MA (S.M.H., B.C., A.M.S., E.F.L., M.A.P., S.D.S.); Department of Cardiology, VA Medical Center and Division of Cardiovascular Medicine, University of Minnesota, Minneapolis (I.A.); Cardiology Division, Northwestern University, Chicago, IL (S.J.S.); Division of Cardiology, University of Arizona, Tucson (N.K.S.); Division of Cardiovascular Medicine, University of Utah, Salt Lake City (J.D.F.); and Cardiovascular Medicine Division, University of Michigan School of Medicine, Ann Arbor (B.P.).
Marc A PfefferFrom Cardiovascular Division, Brigham and Women's Hospital, Boston, MA (S.M.H., B.C., A.M.S., E.F.L., M.A.P., S.D.S.); Department of Cardiology, VA Medical Center and Division of Cardiovascular Medicine, University of Minnesota, Minneapolis (I.A.); Cardiology Division, Northwestern University, Chicago, IL (S.J.S.); Division of Cardiology, University of Arizona, Tucson (N.K.S.); Division of Cardiovascular Medicine, University of Utah, Salt Lake City (J.D.F.); and Cardiovascular Medicine Division, University of Michigan School of Medicine, Ann Arbor (B.P.).
Scott D SolomonFrom Cardiovascular Division, Brigham and Women's Hospital, Boston, MA (S.M.H., B.C., A.M.S., E.F.L., M.A.P., S.D.S.); Department of Cardiology, VA Medical Center and Division of Cardiovascular Medicine, University of Minnesota, Minneapolis (I.A.); Cardiology Division, Northwestern University, Chicago, IL (S.J.S.); Division of Cardiology, University of Arizona, Tucson (N.K.S.); Division of Cardiovascular Medicine, University of Utah, Salt Lake City (J.D.F.); and Cardiovascular Medicine Division, University of Michigan School of Medicine, Ann Arbor (B.P.). ssolomon@rics.bwh.harvard.edu.

Funding

Noninvasive Cardiovascular Imaging Research Training ProgramT32HL094301 · NHLBI · BRIGHAM AND WOMEN'S HOSPITAL · PI Marcelo F DI CARLI · 2010 to 2026
$7.8M
NHLBI NIH HHS HHSN268200425207CNHLBI NIH HHS T32 HL094301
6 · The paper itself

Abstract

backgroundPhysical activity (PA) is inversely associated with adverse cardiovascular outcomes in healthy populations, but the impact of physical activity in patients with heart failure (HF) with preserved ejection fraction is less well characterized.

methodsThe baseline self-reported PA of 1751 subjects enrolled in the Americas region of the TOPCAT trial (Treatment of Preserved Cardiac Function Heart Failure With an Aldosterone Antagonist) was categorized as poor, intermediate, or ideal PA with American Heart Association criteria. PA was related to the primary composite outcome (HF hospitalization, cardiovascular mortality, or aborted cardiac arrest), its components, and all-cause mortality with the use of multivariable Cox models.

resultsThe mean age at enrollment was 68.6±9.6 years. Few patients met American Heart Association criteria for ideal activity (11% ideal, 14% intermediate, 75% poor). Over a median follow-up of 2.4 years, the primary composite outcome occurred in 519 patients (397 HF hospitalizations, 222 cardiovascular deaths, and 6 aborted cardiac arrests). Compared with those with ideal baseline PA, poor and intermediate baseline PA was associated with a greater risk of the primary outcome (hazard ratio [HR], 2.05; 95% confidence interval [CI], 1.28-3.28; HR, 1.95; 95% CI, 1.15-3.33, respectively), HF hospitalization (HR, 1.93; 95% CI, 1.16-3.22; HR, 1.84; 95% CI, 1.02-3.31), cardiovascular mortality (HR, 4.36; 95% CI, 1.37-13.83; HR, 4.05; 95% CI, 1.17-14.04), and all-cause mortality (HR, 2.95; 95% CI, 1.44-6.02; HR, 2.05; 95% CI, 0.90-4.67) after multivariable adjustment for potential confounders.

conclusionsIn patients with HF with preserved ejection fraction, both poor and intermediate self-reported PA were associated with higher risk of HF hospitalization and mortality. CLINICAL

trial registrationURL: https://clinicaltrials.gov. Unique identifier: NCT00094302.

Indexed as

AgedArgentinaBrazilCanadaExerciseFemaleFollow-Up StudiesHeart FailureHumansMaleMiddle AgedMineralocorticoid Receptor AntagonistsMortalityPrognosisStroke VolumeTreatment OutcomeMineralocorticoid Receptor Antagonistsclinical trial [publication type]exerciseheart failurehospitalizationspironolactonetreatment outcome

Identifiers

PMID28637881
PMCPMC6592611

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.