Evidence map›Paper›PMID 33495853›Full record

Trial reportBasic research in cardiology2021

Effect of COMBinAtion therapy with remote ischemic conditioning and exenatide on the Myocardial Infarct size: a two-by-two factorial randomized trial (COMBAT-MI).

Bruno García Del Blanco, Imanol Otaegui, José F Rodríguez-Palomares, Antoni Bayés-Genis, Eduard Fernández-Nofrerías, Victoria Vilalta Del Olmo, Xavier Carrillo, Borja Ibáñez, Fernando Worner, Juan Casanova and 29 more

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

Trial report in Basic research in cardiology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
21citing papers in PubMed, 2 pooled it
3.9field-weighted citation impact, top 6% 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, 2 syntheses or guidelines pooled it, 33 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Trial
  4. A systematic review and meta-analyses of glucagon-like peptide-1 receptor agonists in acute myocardial infarction.The Egyptian heart journal : (EHJ) : official bulletin of the Egyptian Society of Cardiology · 2026
    Review
  5. Review
  6. Review
  7. Observational
  8. Review
  9. Review
  10. Review
  11. Review
  12. Review
  13. Review
  14. Article
  15. Complementary Pharmacotherapy for STEMI Undergoing Primary PCI: An Evidence-Based Clinical Approach.American journal of cardiovascular drugs : drugs, devices, and other interventions · 2022
    Review
  16. Review
  17. Review
  18. Article
  19. Article
  20. Citric Acid Cycle Metabolites Predict Infarct Size inInternational journal of molecular sciences · 2021
    Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

39 authors at 7 institutions in 4 countries.

Bruno García Del BlancoCardiology Department, Vall D'Hebron Institut de Recerca (VHIR), Vall D'Hebron Hospital Universitari, Vall D'Hebron Barcelona Hospital Campus, Universitat Autònoma de Barcelona, Passeig Vall d'Hebron 119-129, 08035, Barcelona, Spain.
Imanol OtaeguiCardiology Department, Vall D'Hebron Institut de Recerca (VHIR), Vall D'Hebron Hospital Universitari, Vall D'Hebron Barcelona Hospital Campus, Universitat Autònoma de Barcelona, Passeig Vall d'Hebron 119-129, 08035, Barcelona, Spain.
José F Rodríguez-PalomaresCardiology Department, Vall D'Hebron Institut de Recerca (VHIR), Vall D'Hebron Hospital Universitari, Vall D'Hebron Barcelona Hospital Campus, Universitat Autònoma de Barcelona, Passeig Vall d'Hebron 119-129, 08035, Barcelona, Spain.
Antoni Bayés-GenisCIBERCV, Instituto de Salud Carlos III, Madrid, Spain.
Eduard Fernández-NofreríasCIBERCV, Instituto de Salud Carlos III, Madrid, Spain.
Victoria Vilalta Del OlmoCIBERCV, Instituto de Salud Carlos III, Madrid, Spain.
Xavier CarrilloCIBERCV, Instituto de Salud Carlos III, Madrid, Spain.
Borja IbáñezCIBERCV, Instituto de Salud Carlos III, Madrid, Spain.
Fernando WornerHospital Universitari Arnau de Vilanova, IRBLLEIDA, Lleida, Spain.
Juan CasanovaHospital Universitari Arnau de Vilanova, IRBLLEIDA, Lleida, Spain.
Eva PueoHospital Universitari Arnau de Vilanova, IRBLLEIDA, Lleida, Spain.
Jose R González-JuanateyHospital Clínico Universitario de Santiago de Compostela, Santiago, Spain.
Javier López-PaisHospital Clínico Universitario de Santiago de Compostela, Santiago, Spain.
Alfredo BardajíServicio de Cardiologia, Hospital Joan XXIII, Tarragona, Spain.
Gil BonetServicio de Cardiologia, Hospital Joan XXIII, Tarragona, Spain.
Mónica FuertesServicio de Cardiologia, Hospital Joan XXIII, Tarragona, Spain.
Antonio Rodríguez-SinovasCardiology Department, Vall D'Hebron Institut de Recerca (VHIR), Vall D'Hebron Hospital Universitari, Vall D'Hebron Barcelona Hospital Campus, Universitat Autònoma de Barcelona, Passeig Vall d'Hebron 119-129, 08035, Barcelona, Spain. antonio.rodriguez.sinovas@vhir.org.ORCID http://orcid.org/0000-0003-2930-8773
Marisol Ruiz-MeanaCardiology Department, Vall D'Hebron Institut de Recerca (VHIR), Vall D'Hebron Hospital Universitari, Vall D'Hebron Barcelona Hospital Campus, Universitat Autònoma de Barcelona, Passeig Vall d'Hebron 119-129, 08035, Barcelona, Spain.
Javier InserteCardiology Department, Vall D'Hebron Institut de Recerca (VHIR), Vall D'Hebron Hospital Universitari, Vall D'Hebron Barcelona Hospital Campus, Universitat Autònoma de Barcelona, Passeig Vall d'Hebron 119-129, 08035, Barcelona, Spain.
Ignasi BarbaCardiology Department, Vall D'Hebron Institut de Recerca (VHIR), Vall D'Hebron Hospital Universitari, Vall D'Hebron Barcelona Hospital Campus, Universitat Autònoma de Barcelona, Passeig Vall d'Hebron 119-129, 08035, Barcelona, Spain.
Sandra Gómez-TalaveraCIBERCV, Instituto de Salud Carlos III, Madrid, Spain.
Gerard MartíCardiology Department, Vall D'Hebron Institut de Recerca (VHIR), Vall D'Hebron Hospital Universitari, Vall D'Hebron Barcelona Hospital Campus, Universitat Autònoma de Barcelona, Passeig Vall d'Hebron 119-129, 08035, Barcelona, Spain.
Bernat SerraCardiology Department, Vall D'Hebron Institut de Recerca (VHIR), Vall D'Hebron Hospital Universitari, Vall D'Hebron Barcelona Hospital Campus, Universitat Autònoma de Barcelona, Passeig Vall d'Hebron 119-129, 08035, Barcelona, Spain.
Neus BelleraCardiology Department, Vall D'Hebron Institut de Recerca (VHIR), Vall D'Hebron Hospital Universitari, Vall D'Hebron Barcelona Hospital Campus, Universitat Autònoma de Barcelona, Passeig Vall d'Hebron 119-129, 08035, Barcelona, Spain.
Manuel Ojeda-RamosCardiology Department, Vall D'Hebron Institut de Recerca (VHIR), Vall D'Hebron Hospital Universitari, Vall D'Hebron Barcelona Hospital Campus, Universitat Autònoma de Barcelona, Passeig Vall d'Hebron 119-129, 08035, Barcelona, Spain.
Hug CuellarInstitut Diagnostic Per La Imatge, Hospital Vall D'Hebron, Barcelona, Spain.
Filipa ValenteCardiology Department, Vall D'Hebron Institut de Recerca (VHIR), Vall D'Hebron Hospital Universitari, Vall D'Hebron Barcelona Hospital Campus, Universitat Autònoma de Barcelona, Passeig Vall d'Hebron 119-129, 08035, Barcelona, Spain.
Maria Ángeles CarmonaCardiology Department, Vall D'Hebron Institut de Recerca (VHIR), Vall D'Hebron Hospital Universitari, Vall D'Hebron Barcelona Hospital Campus, Universitat Autònoma de Barcelona, Passeig Vall d'Hebron 119-129, 08035, Barcelona, Spain.
Elisabet Miró-CasasCardiology Department, Vall D'Hebron Institut de Recerca (VHIR), Vall D'Hebron Hospital Universitari, Vall D'Hebron Barcelona Hospital Campus, Universitat Autònoma de Barcelona, Passeig Vall d'Hebron 119-129, 08035, Barcelona, Spain.
Josep R MarsalCardiology Department, Vall D'Hebron Institut de Recerca (VHIR), Vall D'Hebron Hospital Universitari, Vall D'Hebron Barcelona Hospital Campus, Universitat Autònoma de Barcelona, Passeig Vall d'Hebron 119-129, 08035, Barcelona, Spain.
Antonia SambolaCardiology Department, Vall D'Hebron Institut de Recerca (VHIR), Vall D'Hebron Hospital Universitari, Vall D'Hebron Barcelona Hospital Campus, Universitat Autònoma de Barcelona, Passeig Vall d'Hebron 119-129, 08035, Barcelona, Spain.
Rosa M LidónCardiology Department, Vall D'Hebron Institut de Recerca (VHIR), Vall D'Hebron Hospital Universitari, Vall D'Hebron Barcelona Hospital Campus, Universitat Autònoma de Barcelona, Passeig Vall d'Hebron 119-129, 08035, Barcelona, Spain.
Jordi BañerasCardiology Department, Vall D'Hebron Institut de Recerca (VHIR), Vall D'Hebron Hospital Universitari, Vall D'Hebron Barcelona Hospital Campus, Universitat Autònoma de Barcelona, Passeig Vall d'Hebron 119-129, 08035, Barcelona, Spain.
Jaime ElízagaCIBERCV, Instituto de Salud Carlos III, Madrid, Spain.
Ferran PadillaCardiology Department, Hospital Universitari Mútua Terrassa, Terrassa, Spain.
José A BarrabésCardiology Department, Vall D'Hebron Institut de Recerca (VHIR), Vall D'Hebron Hospital Universitari, Vall D'Hebron Barcelona Hospital Campus, Universitat Autònoma de Barcelona, Passeig Vall d'Hebron 119-129, 08035, Barcelona, Spain.
Derek J HausenloyDuke-National University of Singapore Medical School, Cardiovascular and Metabolic Disorders Program, Singapore, Singapore.
Ignacio Ferreira-GonzálezCardiology Department, Vall D'Hebron Institut de Recerca (VHIR), Vall D'Hebron Hospital Universitari, Vall D'Hebron Barcelona Hospital Campus, Universitat Autònoma de Barcelona, Passeig Vall d'Hebron 119-129, 08035, Barcelona, Spain. iferreir@vhebron.net.
David García-DoradoCardiology Department, Vall D'Hebron Institut de Recerca (VHIR), Vall D'Hebron Hospital Universitari, Vall D'Hebron Barcelona Hospital Campus, Universitat Autònoma de Barcelona, Passeig Vall d'Hebron 119-129, 08035, Barcelona, Spain.
Universitat Autònoma de Barcelona · ESInstituto de Salud Carlos III · ESHospital Universitari Arnau de Vilanova · ESHospital Universitari Joan XXIII de Tarragona · ESComplejo Hospitalario Universitario de Santiago · ESAsia University · TWMútua Terrassa · ES

Funding

British Heart Foundation CS/14/3/31002Departament de Salut, Generalitat de Catalunya PERIS SLT/2381/2016Instituto de Salud Carlos III PIE 13/00027Medical Research Council MC_G1002673
6 · The paper itself

Abstract

Remote ischemic conditioning (RIC) and the GLP-1 analog exenatide activate different cardioprotective pathways and may have additive effects on infarct size (IS). Here, we aimed to assess the efficacy of RIC as compared with sham procedure, and of exenatide, as compared with placebo, and the interaction between both, to reduce IS in humans. We designed a two-by-two factorial, randomized controlled, blinded, multicenter, clinical trial. Patients with ST-segment elevation myocardial infarction receiving primary percutaneous coronary intervention (PPCI) within 6 h of symptoms were randomized to RIC or sham procedure and exenatide or matching placebo. The primary outcome was IS measured by late gadolinium enhancement in cardiac magnetic resonance performed 3-7 days after PPCI. The secondary outcomes were myocardial salvage index, transmurality index, left ventricular ejection fraction and relative microvascular obstruction volume. A total of 378 patients were randomly allocated, and after applying exclusion criteria, 222 patients were available for analysis. There were no significant interactions between the two randomization factors on the primary or secondary outcomes. IS was similar between groups for the RIC (24 ± 11.8% in the RIC group vs 23.7 ± 10.9% in the sham group, P = 0.827) and the exenatide hypotheses (25.1 ± 11.5% in the exenatide group vs 22.5 ± 10.9% in the placebo group, P = 0.092). There were no effects with either RIC or exenatide on the secondary outcomes. Unexpected adverse events or side effects of RIC and exenatide were not observed. In conclusion, neither RIC nor exenatide, or its combination, were able to reduce IS in STEMI patients when administered as an adjunct to PPCI.

Indexed as

Ischemic PreconditioningPercutaneous Coronary InterventionAgedArmCombined Modality TherapyDouble-Blind MethodExenatideFemaleHumansIncretinsMagnetic Resonance Imaging, CineMaleMiddle AgedMyocardiumProspective StudiesRegional Blood FlowExenatideIncretinsExenatidePrimary percutaneous coronary interventionRemote ischemic conditioningST-segment elevation acute myocardial infarction

Identifiers

PMID33495853
OpenAlexW3122020047

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.