Evidence map›Paper›PMID 28960777›Full record

Trial reportEuropean journal of heart failure2018

Prognostic importance of emerging cardiac, inflammatory, and renal biomarkers in chronic heart failure patients with reduced ejection fraction and anaemia: RED-HF study.

Paul Welsh, Lei Kou, Changhong Yu, Inder Anand, Dirk J van Veldhuisen, Aldo P Maggioni, Akshay S Desai, Scott D Solomon, Marc A Pfeffer, Sunfa Cheng and 8 more

Open access · hybridAbstract readMulticenter StudyRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in European journal of heart failure, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 34 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
34citing papers in PubMed, 4 pooled it
3.7field-weighted citation impact, top 5% 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

34 citing papers in PubMed, 4 syntheses or guidelines pooled it, 54 citations in OpenAlex.

  1. Pooled it
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  3. Highlights in heart failure.ESC heart failure · 2019
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  17. Translational studies of adrenomedullin and related peptides regarding cardiovascular diseases.Hypertension research : official journal of the Japanese Society of Hypertension · 2022
    Review
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

18 authors at 10 institutions in 6 countries.

Paul WelshInstitute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK.
Lei KouDepartment of Quantitative Health Sciences, Cleveland Clinic, Cleveland, OH, USA.
Changhong YuDepartment of Quantitative Health Sciences, Cleveland Clinic, Cleveland, OH, USA.
Inder AnandVA Medical Center, University of Minnesota, Minneapolis, MN, USA.
Dirk J van VeldhuisenUniversity Medical Center, Groningen, The Netherlands.
Aldo P MaggioniANMCO Research Center, Florence, Italy.
Akshay S DesaiCardiovascular Division, Brigham and Women's Hospital, Boston, MA, USA.
Scott D SolomonCardiovascular Division, Brigham and Women's Hospital, Boston, MA, USA.
Marc A PfefferCardiovascular Division, Brigham and Women's Hospital, Boston, MA, USA.
Sunfa ChengAmgen, Thousand Oaks, CA, USA.
Lars GullestadDepartment of Cardiology, Oslo University Hospital, Rikshospitalet, Oslo, Norway.
Pål AukrustInstitute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway.
Thor UelandInstitute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway.
Karl SwedbergUniversity of Gothenburg, Gothenburg, Sweden, and National Heart and Lung Institute, Imperial College, London, UK.
James B YoungDepartment of Quantitative Health Sciences, Cleveland Clinic, Cleveland, OH, USA.
Michael W KattanDepartment of Quantitative Health Sciences, Cleveland Clinic, Cleveland, OH, USA.
Naveed SattarInstitute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK.
John J V McMurrayInstitute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK.
Cleveland Clinic · USBrigham and Women's Hospital · USUniversity of Glasgow · GBUniversity of Oslo · NOAmgen (United States) · USFlorence (Netherlands) · NLMinneapolis VA Medical Center · USOslo University Hospital · NOUniversity Medical Center Groningen · NLUniversity of Gothenburg · SE

Funding

British Heart Foundation FS/12/62/29889
6 · The paper itself

Abstract

aimsTo test the prognostic value of emerging biomarkers in the Reduction of Events by Darbepoetin Alfa in Heart Failure (RED-HF) trial. METHODS AND

resultsCirculating cardiac [N-terminal pro-B-type natriuretic peptide (NT-proBNP), and high-sensitivity troponin T (hsTnT)], neurohumoral [mid-regional pro-adrenomedullin (MR-proADM) and copeptin], renal (cystatin C), and inflammatory [high-sensitivity C-reactive protein (hsCRP)] biomarkers were measured at randomization in 1853 participants with complete data. The relationship between these biomarkers and the primary composite endpoint of heart failure hospitalization or cardiovascular death over 28 months of follow-up (n = 834) was evaluated using Cox proportional hazards regression, the c-statistic and the net reclassification index (NRI). After adjustment, the hazard ratio (HR) for the composite outcome in the top tertile of the distribution compared to the lowest tertile for each biomarker was: NT-proBNP 3.96 (95% CI 3.16-4.98), hsTnT 3.09 (95% CI 2.47-3.88), MR-proADM 2.28 (95% CI 1.83-2.84), copeptin 1.66 (95% CI 1.35-2.04), cystatin C 1.92 (95% CI 1.55-2.37), and hsCRP 1.51 (95% CI 1.27-1.80). A basic clinical prediction model was improved on addition of each biomarker individually, most strongly by NT-proBNP (NRI +62.3%, P < 0.001), but thereafter was only improved marginally by addition of hsTnT (NRI +33.1%, P = 0.004). Further addition of biomarkers did not improve discrimination further. Findings were similar for all-cause mortality.

conclusionOnce NT-proBNP is included, only hsTnT moderately further improved risk stratification in this group of chronic heart failure with reduced ejection fraction patients with moderate anaemia. NT-proBNP and hsTnT far outperform other emerging biomarkers in prediction of adverse outcome.

Indexed as

AgedAnemiaBiomarkersCause of DeathC-Reactive ProteinDarbepoetin alfaDose-Response Relationship, DrugDouble-Blind MethodEuropeFemaleFollow-Up StudiesHeart FailureHematinicsHumansKidneyMaleBiomarkersC-Reactive ProteinDarbepoetin alfaHematinicsNatriuretic Peptide, BrainPeptide Fragmentspro-brain natriuretic peptide (1-76)Troponin TAdrenomedullinCopeptinCystatin CHeart failureNatriuretic peptidesTroponin

Identifiers

PMID28960777
PMCPMC6607475
OpenAlexW2758538645

What OpenQuestion holds

Textmetadata
LicenceCC BY
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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.