Evidence map›Paper›PMID 28774396›Full record

Trial reportJACC. Heart failure2017

Aspirin Does Not Increase Heart Failure Events in Heart Failure Patients: From the WARCEF Trial.

John R Teerlink, Min Qian, Natalie A Bello, Ronald S Freudenberger, Bruce Levin, Marco R Di Tullio, Susan Graham, Douglas L Mann, Ralph L Sacco, J P Mohr and 9 more

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

Trial report in JACC. Heart failure, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT00041938 (Warfarin Versus Aspirin in Reduced Cardiac Ejection Fraction), which is not on this map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
0.5field-weighted citation impact, top 30% 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.

NCT00041938 phase3completednot on this map

Warfarin Versus Aspirin in Reduced Cardiac Ejection Fraction (WARCEF) Trial

TypeinterventionalSponsorColumbia UniversityRan2002 to 2014Enrolled2,305ConditionsHeart Disease, Stroke, Ischemic Heart Disease, Myocardial InfarctionArmsaspirin, Warfarin
3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 7 citations in OpenAlex.

  1. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

19 authors at 10 institutions in 4 countries.

John R TeerlinkSection of Cardiology, San Francisco Veterans Affairs Medical Center and School of Medicine, University of California San Francisco, San Francisco, California.
Min QianColumbia University Medical Center, New York, New York.
Natalie A BelloColumbia University Medical Center, New York, New York.
Ronald S FreudenbergerLehigh Valley Hospital, Allentown, Pennsylvania.
Bruce LevinColumbia University Medical Center, New York, New York.
Marco R Di TullioColumbia University Medical Center, New York, New York.
Susan GrahamState University of New York at Buffalo, Buffalo, New York.
Douglas L MannWashington University, St. Louis, Missouri.
Ralph L SaccoUniversity of Miami, Miami, Florida.
J P MohrColumbia University Medical Center, New York, New York.
Gregory Y H LipInstitute of Birmingham Centre for Cardiovascular Sciences, Birmingham, England, United Kingdom.
Arthur J LabovitzUniversity of South Florida, Tampa, Florida.
Seitetz C LeeColumbia University Medical Center, New York, New York.
Piotr PonikowskiMilitary Hospital, Wroclaw, Poland.
Dirk J LokDeventer Hospital, Deventer, the Netherlands.
Stefan D AnkerInnovative Clinical Trials, Department of Cardiology & Pneumology, University Medical Center Göttingen (UMG), Göttingen, Germany.
John L P ThompsonColumbia University Medical Center, New York, New York.
Shunichi HommaColumbia University Medical Center, New York, New York. Electronic address: sh23@cumc.columbia.edu.
WARCEF Investigators
Columbia University Irving Medical Center · USDeventer Ziekenhuis · NLLehigh Valley Hospital · USNIHR Birmingham Biomedical Research Centre · GBSan Francisco VA Medical Center · USUniversitätsmedizin Göttingen · DEUniversity at Buffalo, State University of New York · USUniversity of Miami · USUniversity of South Florida · USWashington University in St. Louis · US

Funding

Warfarin vs. Aspirin in Reduced Ejection Fraction (WARCEF)U01NS043975 · NINDS · UNIV OF MED/DENT OF NJ-NJ MEDICAL SCHOOL · PI HOMMA, SHUNICHI · 2001 to 2010
$43.3M
Warfarin vs Aspirin in Reduced Ejection Fraction -STATU01NS039143 · NINDS · COLUMBIA UNIVERSITY HEALTH SCIENCES · PI THOMPSON, JOHN L · 2001 to 2010
$21.3M
NHLBI NIH HHS L30 HL129418NINDS NIH HHS U01 NS039143NINDS NIH HHS U01 NS043975
6 · The paper itself

Abstract

objectivesThe aim of this study was to determine whether aspirin increases heart failure (HF) hospitalization or death in patients with HF with reduced ejection fraction receiving an angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB).

backgroundBecause of its cyclooxygenase inhibiting properties, aspirin has been postulated to increase HF events in patients treated with ACE inhibitors or ARBs. However, no large randomized trial has addressed the clinical relevance of this issue.

methodsWe compared aspirin and warfarin for HF events (hospitalization, death, or both) in the 2,305 patients enrolled in the WARCEF (Warfarin versus Aspirin in Reduced Cardiac Ejection Fraction) trial (98.6% on ACE inhibitor or ARB treatment), using conventional Cox models for time to first event (489 events). In addition, to examine multiple HF hospitalizations, we used 2 extended Cox models, a conditional model and a total time marginal model, in time to recurrent event analyses (1,078 events).

resultsAfter adjustment for baseline covariates, aspirin- and warfarin-treated patients did not differ in time to first HF event (adjusted hazard ratio: 0.87; 95% confidence interval: 0.72 to 1.04; p = 0.117) or first hospitalization alone (adjusted hazard ratio: 0.88; 95% confidence interval: 0.73 to 1.06; p = 0.168). The extended Cox models also found no significant differences in all HF events or in HF hospitalizations alone after adjustment for covariates.

conclusionsAmong patients with HF with reduced ejection fraction in the WARCEF trial, there was no significant difference in risk of HF events between the aspirin and warfarin-treated patients. (Warfarin Versus Aspirin in Reduced Cardiac Ejection Fraction trial [WARCEF]; NCT00041938).

Indexed as

Angiotensin-Converting Enzyme InhibitorsAngiotensin Receptor AntagonistsAnticoagulantsAspirinCyclooxygenase InhibitorsDouble-Blind MethodFemaleHeart FailureHospitalizationHumansKaplan-Meier EstimateMaleMiddle AgedStroke VolumeWarfarinAngiotensin-Converting Enzyme InhibitorsAngiotensin Receptor AntagonistsAnticoagulantsAspirinCyclooxygenase InhibitorsWarfarinaspirinheart failurehospitalizationsurvivalwarfarin

Identifiers

PMID28774396
PMCPMC5570544
OpenAlexW2741652112

What OpenQuestion holds

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LicenceTDM
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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.