Evidence map›Paper›PMID 30604047›Full record

Trial reportClinical research in cardiology : official journal of the German Cardiac Society2019

Impact of eplerenone on major cardiovascular outcomes in patients with systolic heart failure according to baseline heart rate.

Ken Lee Chin, Timothy Collier, Stuart Pocock, Bertram Pitt, John J V McMurray, Dirk J van Veldhuisen, Karl Swedberg, John Vincent, Faiez Zannad, Danny Liew

Open access · greenAbstract readMulticenter StudyRandomized Controlled Trial
PubMed Publisher
In one paragraph

Trial report in Clinical research in cardiology : official journal of the German Cardiac Society, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
0.8field-weighted citation impact, top 26% 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

6 citing papers in PubMed, 8 citations in OpenAlex.

  1. Article
  2. Article
  3. Article
  4. Time-updated resting heart rate predicts mortality in patients with COPD.Clinical research in cardiology : official journal of the German Cardiac Society · 2020
    Article
  5. Review
  6. Article
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

10 authors at 8 institutions in 6 countries.

Ken Lee ChinDepartment of Epidemiology and Preventive Medicine, CCRE Therapeutics, Monash University/Alfred Hospital, 553 St Kilda Rd, Melbourne, VIC, 3004, Australia. ken.chin@monash.edu.
Timothy CollierLondon School of Hygiene and Tropical Medicine, London, UK.
Stuart PocockLondon School of Hygiene and Tropical Medicine, London, UK.
Bertram PittUniversity of Michigan, Ann Arbor, USA.
John J V McMurrayUniversity of Glasgow, Glasgow, UK.
Dirk J van VeldhuisenUniversity Medical Centre, Groningen, The Netherlands.
Karl SwedbergUniversity of Gothenburg, Gothenburg, Sweden.
John VincentPfizer, New York, USA.
Faiez ZannadNancy University, Nancy, France.
Danny LiewDepartment of Epidemiology and Preventive Medicine, CCRE Therapeutics, Monash University/Alfred Hospital, 553 St Kilda Rd, Melbourne, VIC, 3004, Australia.
London School of Hygiene & Tropical Medicine · GBMonash University · AUCentre Hospitalier Régional et Universitaire de Nancy · FRImperial College London · GBPfizer (United States) · USUniversity Medical Center Groningen · NLUniversity of Glasgow · GBUniversity of Michigan–Ann Arbor · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundIncreased resting heart rate is a risk factor for cardiovascular mortality and morbidity. Mineralocorticoid receptor antagonists (MRAs) have been shown to improve cardiac sympathetic nerve activity, reduce heart rate and attenuate left ventricular remodelling. Whether or not the beneficial effects of MRA are affected by heart rate in heart failure patients with reduced ejection fraction (HFREF) is unclear.

methodsWe undertook a secondary analysis of data from the Eplerenone in Mild Patients Hospitalization and Survival Study in Heart Failure study to assess if clinical outcomes, as well as the efficacy of eplerenone, varied according to heart rate at baseline.

resultsHigh resting heart rate of 80 bpm and above predisposed patients to greater risk of all outcomes in the trial, regardless of treatment allocation. The beneficial effects of eplerenone were observed across all categories of heart rate. Eplerenone reduced the risk of primary endpoint, the composite of cardiovascular death and hospitalisation for heart failure, by 30% (aHR 0.70; 95% CI 0.54-0.91) in subjects with heart rate ≥ 80 bpm, and by 48% (aHR 0.52; 95% CI 0.33-0.81) in subjects with heart rate ≤ 60 bpm. Eplerenone also reduced the risks of hospitalisation for heart failure, cardiovascular deaths and all-cause deaths independently of baseline heart rate.

conclusionsBaseline heart rate appears to be an important predictor of major clinical outcome events in patients with HFREF, as has been previously reported. The benefits of eplerenone were preserved across all categories of baseline heart rate, without observed heterogeneity in the responses.

Indexed as

Dose-Response Relationship, DrugEplerenoneEuropeFemaleHeart Failure, SystolicHeart RateHumansMaleMiddle AgedMineralocorticoid Receptor AntagonistsRisk FactorsStroke VolumeSurvival RateTreatment OutcomeUnited StatesEplerenoneMineralocorticoid Receptor AntagonistsAldosteroneAldosterone antagonistsClinicalTrials.gov identifier: NCT00232180Heart failureHeart rate

Identifiers

PMID30604047
OpenAlexW2907968472

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

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.