Evidence map›Paper›PMID 33438360›Full record

ArticleESC heart failure2021

Impact of diabetes on serum biomarkers in heart failure with preserved ejection fraction: insights from the TOPCAT trial.

Corrado De Marco, Brian L Claggett, Simon de Denus, Michael R Zile, Thao Huynh, Akshay S Desai, Martin G Sirois, Scott D Solomon, Bertram Pitt, Jean L Rouleau and 2 more

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in ESC heart failure, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
21citing papers in PubMed, 3 pooled it
4.1field-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

21 citing papers in PubMed, 3 syntheses or guidelines pooled it, 28 citations in OpenAlex.

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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

12 authors at 6 institutions in 2 countries.

Corrado De MarcoDivision of Cardiology, Montreal Heart Institute and Université de Montréal, 5000 rue Bélanger, Montreal, QC, H1T 1C8, Canada.
Brian L ClaggettCardiovascular Division, Brigham and Women's Hospital, Boston, MA, USA.
Simon de DenusDivision of Cardiology, Montreal Heart Institute and Université de Montréal, 5000 rue Bélanger, Montreal, QC, H1T 1C8, Canada.
Michael R ZileDivision of Cardiology, Medical University of South Carolina, Charleston, SC, USA.
Thao HuynhMcGill University Health Centre and McGill University, Montreal, QC, Canada.
Akshay S DesaiCardiovascular Division, Brigham and Women's Hospital, Boston, MA, USA.
Martin G SiroisDivision of Cardiology, Montreal Heart Institute and Université de Montréal, 5000 rue Bélanger, Montreal, QC, H1T 1C8, Canada.
Scott D SolomonCardiovascular Division, Brigham and Women's Hospital, Boston, MA, USA.
Bertram PittUniversity of Michigan School of Medicine, Ann Arbor, MI, USA.
Jean L RouleauDivision of Cardiology, Montreal Heart Institute and Université de Montréal, 5000 rue Bélanger, Montreal, QC, H1T 1C8, Canada.
Marc A PfefferCardiovascular Division, Brigham and Women's Hospital, Boston, MA, USA.
Eileen O'MearaDivision of Cardiology, Montreal Heart Institute and Université de Montréal, 5000 rue Bélanger, Montreal, QC, H1T 1C8, Canada.
Brigham and Women's Hospital · USMontreal Heart Institute · CAUniversité de Montréal · CAMcGill University Health Centre · CAMedical University of South Carolina · USUniversity of Michigan · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

aimsDiabetes mellitus (DM) is common in heart failure with preserved ejection fraction (HFpEF). Patients with DM and heart failure with reduced ejection fraction have higher levels of cardiac, profibrotic, and proinflammatory biomarkers relative to non-diabetics. Limited data are available regarding the biomarker profiles of HFpEF patients with diabetes (DM) vs. no diabetes (non-DM) and the impact of spironolactone on these biomarkers. This study aims to address such gaps in the literature. METHODS AND

resultsBiomarkers were measured at randomization and at 12 months in 248 patients enrolled in Treatment of Preserved Cardiac Function Heart Failure with an Aldosterone Antagonist's North American cohort. At baseline, DM patients had significantly lower estimated glomerular filtration rate and higher high-sensitivity C-reactive protein, pro-collagen type III amino-terminal peptide, tissue inhibitor of metalloproteinase 1 (TIMP-1), and galectin-3 levels than those without diabetes. There was a significantly larger 12 month increase in levels of high-sensitivity troponin T (hs-TnT), a marker of myocyte death, in DM patients. Elevated pro-collagen type III amino-terminal peptide and galectin-3 levels were associated with an increased risk of the primary outcome (cardiovascular mortality, aborted cardiac arrest, or heart failure hospitalization) in DM patients, but not in those without diabetes. A statistically significant interaction between spironolactone and diabetes status was observed for hs-TnT and for TIMP-1, with greater biomarker reductions among those with diabetes treated with spironolactone.

conclusionsThe presence of diabetes is associated with higher levels of cardiac, profibrotic, and proinflammatory biomarkers in HFpEF. Spironolactone appears to alter the determinants of extracellular matrix remodelling in an anti-fibrotic fashion in patients with diabetes, reflected by changes in hs-TnT and TIMP-1 levels over time.

Indexed as

Diabetes MellitusHeart FailureBiomarkersHumansMineralocorticoid Receptor AntagonistsStroke VolumeTissue Inhibitor of Metalloproteinase-1BiomarkersMineralocorticoid Receptor AntagonistsTissue Inhibitor of Metalloproteinase-1BiomarkerDiabetesHeart failurePreserved left ventricular functionSpironolactone

Identifiers

PMID33438360
PMCPMC8006665
OpenAlexW3120111174

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
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.