Trial reportThe American journal of cardiology2019
Comparison of Outcomes in Patients With Diabetes Mellitus Treated With Versus Without Insulin + Heart Failure With Preserved Left Ventricular Ejection Fraction (from the TOPCAT Study).
Trial report in The American journal of cardiology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 1 of them a synthesis that pooled 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.
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.
Who cites it
14 citing papers in PubMed, 1 synthesis or guideline pooled it, 27 citations in OpenAlex.
- Impact of insulin therapy on outcomes of diabetic patients with heart failure: A systematic review and meta-analysis.Diabetes & vascular disease researchPooled it
- Finerenone, glycaemic status, and heart failure with mildly reduced or preserved ejection fraction: A prespecified analysis of the FINEARTS-HF trial.European journal of heart failure · 2025Trial
- Diabetes and pre-diabetes in patients with heart failure and preserved ejection fraction.European journal of heart failure · 2022Trial
- Machine learning-based prediction of mortality and hospitalization in diabetic patients with heart failure with preserved ejection fraction: the GUARDIAN-P risk score.European heart journal. Digital health · 2026Article
- Albuminuria Is the Key Driver of Kidney Benefit with Aldosterone Receptor Antagonists in Type 2 Diabetes.Journal of the American Society of Nephrology : JASN · 2026Article
- New Mechanisms to Prevent Heart Failure with Preserved Ejection Fraction Using Glucagon-like Peptide-1 Receptor Agonism (GLP-1 RA) in Metabolic Syndrome and in Type 2 Diabetes: A Review.International journal of molecular sciences · 2024Review
- Pharmacotherapy of diabetes mellitus in patients with heart failure - a nation-wide analysis of contemporary treatment.Biomedical papers of the Medical Faculty of the University Palacky, Olomouc, Czechoslovakia · 2023Article
- The Diabetic Cardiorenal Nexus.International journal of molecular sciences · 2022Review
- Effects of sacubitril/valsartan on glycemia in patients with diabetes and heart failure: the PARAGON-HF and PARADIGM-HF trials.Cardiovascular diabetology · 2022Article
- Impact of insulin therapy on the mortality of acute heart failure patients with diabetes mellitus.Cardiovascular diabetology · 2021Observational
- STZ-diabetic rat heart maintains developed tension amplitude by increasing sarcomere length and crossbridge density.Experimental physiology · 2021Article
- Diabetes Mellitus and Heart Failure With Preserved Ejection Fraction: Role of Obesity.Frontiers in physiology · 2021Review
- Insulin treatment and clinical outcomes in patients with diabetes and heart failure with preserved ejection fraction.European journal of heart failure · 2019Article
- Type 2 diabetes mellitus increases long-term mortality risk after isolated surgical aortic valve replacement.Cardiovascular diabetology · 2019Observational
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
14 authors at 8 institutions in 2 countries.
Funding
Abstract
We aimed to evaluate the impact of diabetes mellitus (DM) and insulin treatment on clinical outcomes in patients with heart failure and preserved left ventricular ejection fraction enrolled in the TOPCAT study. We investigated the influence of DM status (insulin-treated [ITDM], non-insulin treated [NITDM], and no diabetes [non-DM]) at baseline on time to development of the primary end point, a composite of cardiovascular (CV) mortality, heart failure hospitalization, and aborted cardiac arrest. Secondary end points included the individual components of the primary end point, myocardial infarction, stroke, all-cause mortality, hyperkalemia, and worsened renal function. Due to marked regional differences in characteristics and outcomes of the TOPCAT patients, with much lower events in patients enrolled in Russia/Georgia, we restricted our analyses on findings from patients enrolled from the Americas. Compared to patients without DM, patients with ITDM had approximately 2-fold increased risk for the primary end point, heart failure hospitalization, and myocardial infarction (hazard ratios: 1.80, 1.97, and 2.27, respectively) and approximately 50% increases in all-cause and CV mortality. The risks for these outcomes were also increased in patients with ITDM in comparison to patients with NITDM as well (hazard ratios: 1.63, 1.65, and 2.73, respectively, and approximately 40% increases in all-cause and CV mortality). Patients with NITDM had similar risks for the primary end point and all secondary end points as patients without DM. In conclusion, the apparent increased risk of adverse outcomes in patients with heart failure and preserved left ventricular ejection fraction and ITDM merits future research to improve the prognosis of these high-risk patients.
Indexed as
Identifiers
What OpenQuestion holds
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.