Evidence map›Paper›PMID 29897923›Full record

ArticlePloS one2018

Elevated plasma angiotensin converting enzyme 2 activity is an independent predictor of major adverse cardiac events in patients with obstructive coronary artery disease.

Jay Ramchand, Sheila K Patel, Piyush M Srivastava, Omar Farouque, Louise M Burrell

2 registry-linked trialsAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in PloS one, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 123 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
123citing papers in PubMed, 4 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.

NCT04338009 nacompletednot on this mapstarted 2020, after this paper: background citation

The Randomized Elimination or Prolongation of Angiotensin Converting Enzyme Inhibitors and Angiotensin Receptor Blockers in Coronavirus Disease 2019

TypeinterventionalSponsorUniversity of PennsylvaniaRan2020 to 2020Enrolled152ConditionsCOVID-19ArmsDiscontinuation of ARB/ACEI, Continuation of ARB/ACEI
NCT04340921 withdrawnnot on this mapstarted 2020, after this paper: background citation

The Role of Adaptive Immunity in COVID-19 Associated Myocardial Injury

TypeobservationalSponsorBarts & The London NHS TrustRan2020 to 2023Enrolled0ConditionsCardiovascular Disease Acute, Cardiomyopathies, COVIDArmsCOVID-19 exposure
3 · Its place in the literature

Who cites it

123 citing papers in PubMed, 4 syntheses or guidelines pooled it.

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63 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Jay RamchandDepartment of Medicine, The University of Melbourne, Austin Health, Heidelberg, Victoria, Australia.
Sheila K PatelDepartment of Medicine, The University of Melbourne, Austin Health, Heidelberg, Victoria, Australia.
Piyush M SrivastavaDepartment of Medicine, The University of Melbourne, Austin Health, Heidelberg, Victoria, Australia.
Omar FarouqueDepartment of Medicine, The University of Melbourne, Austin Health, Heidelberg, Victoria, Australia.
Louise M BurrellDepartment of Medicine, The University of Melbourne, Austin Health, Heidelberg, Victoria, Australia.ORCID 0000-0003-1863-7539

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAngiotensin converting enzyme 2 (ACE2) is an endogenous regulator of the renin angiotensin system. Increased circulating ACE2 predicts adverse outcomes in patients with heart failure (HF), but it is unknown if elevated plasma ACE2 activity predicts major adverse cardiovascular events (MACE) in patients with obstructive coronary artery disease (CAD).

methodsWe prospectively recruited patients with obstructive CAD (defined as ≥50% stenosis of the left main coronary artery and/or ≥70% stenosis in ≥ 1 other major epicardial vessel on invasive coronary angiography) and measured plasma ACE2 activity. Patients were followed up to determine if circulating ACE2 activity levels predicted the primary endpoint of MACE (cardiovascular mortality, HF or myocardial infarction).

resultsWe recruited 79 patients with obstructive coronary artery disease. The median (IQR) plasma ACE2 activity was 29.3 pmol/ml/min [21.2-41.2]. Over a median follow up of 10.5 years [9.6-10.8years], MACE occurred in 46% of patients (36 events). On Kaplan-Meier analysis, above-median plasma ACE2 activity was associated with MACE (log-rank test, p = 0.035) and HF hospitalisation (p = 0.01). After Cox multivariable adjustment, log ACE2 activity remained an independent predictor of MACE (hazard ratio (HR) 2.4, 95% confidence interval (CI) 1.24-4.72, p = 0.009) and HF hospitalisation (HR: 4.03, 95% CI: 1.42-11.5, p = 0.009).

conclusionsPlasma ACE2 activity independently increased the hazard of adverse long-term cardiovascular outcomes in patients with obstructive CAD.

Indexed as

AgedAngiotensin-Converting Enzyme 2BiomarkersCoronary AngiographyCoronary Artery DiseaseCoronary OcclusionFemaleFollow-Up StudiesHeart FailureHumansMaleMiddle AgedMyocardial InfarctionPeptidyl-Dipeptidase APrognosisTomography, X-Ray ComputedACE2 protein, humanAngiotensin-Converting Enzyme 2BiomarkersPeptidyl-Dipeptidase A

Identifiers

PMID29897923
PMCPMC5999069

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.