Evidence map›Paper›PMID 34384742›Full record

Trial reportAmerican heart journal2021

Cardiovascular risk and outcomes in symptomatic patients with suspected coronary artery disease and non coronary vascular disease: A report from the PROMISE trial.

Sreekanth Vemulapalli, Amanda Stebbins, W Schuyler Jones, J Antonio Gutierrez, Manesh R Patel, Rowena J Dolor, Patricia A Pellikka, Brooke Alhanti, Udo Hoffmann, Pamela S Douglas

Open access · greenAbstract readRandomized Controlled Trial
In one paragraph

Trial report in American heart journal, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact, top 86% 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

0 citing papers in PubMed, 0 citations in OpenAlex.

No citing paper in PubMed yet.

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 4 institutions in 1 country.

Sreekanth VemulapalliDuke Clinical Research Institute, Durham, NC; Division of Cardiology, Department of Medicine, Duke University School of Medicine, Durham, NC. Electronic address: sreekanth.vemulapalli@duke.edu.
Amanda StebbinsDuke Clinical Research Institute, Durham, NC.
W Schuyler JonesDuke Clinical Research Institute, Durham, NC; Division of Cardiology, Department of Medicine, Duke University School of Medicine, Durham, NC.
J Antonio GutierrezDuke Clinical Research Institute, Durham, NC; Division of Cardiology, Department of Medicine, Duke University School of Medicine, Durham, NC.
Manesh R PatelDuke Clinical Research Institute, Durham, NC; Division of Cardiology, Department of Medicine, Duke University School of Medicine, Durham, NC.
Rowena J DolorDuke Clinical Research Institute, Durham, NC; Division of General Internal Medicine, Department of Medicine, Duke University School of Medicine, Durham, NC.
Patricia A PellikkaDepartment of Cardiovascular Medicine, Mayo Clinic School of Medicine, Rochester, MN.
Brooke AlhantiDuke Clinical Research Institute, Durham, NC.
Udo HoffmannMassachusetts General Hospital, Boston, MA.
Pamela S DouglasDuke Clinical Research Institute, Durham, NC; Division of Cardiology, Department of Medicine, Duke University School of Medicine, Durham, NC.
Duke University · USClinical Research Institute · USMassachusetts General Hospital · USMayo Clinic in Arizona · US

Funding

PROMISE Trial: Clinical Coordinating CenterR01HL098237 · NHLBI · DUKE UNIVERSITY · PI DOUGLAS, PAMELA SUSAN · 2009 to 2014
$27.3M
PROMISE Trial: SDCCR01HL098236 · NHLBI · DUKE UNIVERSITY · PI LEE, KERRY L · 2009 to 2014
$5.0M
PROMISE Trial: Dx CoreR01HL098305 · NHLBI · MASSACHUSETTS GENERAL HOSPITAL · PI HOFFMANN, UDO · 2009 to 2014
$3.5M
PROMISE Trial: Substudy to Assess for Effective Dose of RadiationR01HL109711 · NHLBI · COLUMBIA UNIVERSITY HEALTH SCIENCES · PI EINSTEIN, ANDREW · 2011 to 2015
$2.5M
PROMISE Trial: EQOL Coordinating CenterR01HL098235 · NHLBI · DUKE UNIVERSITY · PI MARK, DANIEL B · 2009 to 2014
$1.6M
NHLBI NIH HHS R01 HL098235NHLBI NIH HHS R01 HL098236NHLBI NIH HHS R01 HL098237NHLBI NIH HHS R01 HL098305NHLBI NIH HHS R01 HL109711
6 · The paper itself

Abstract

backgroundNon-coronary vascular disease (NCVD) is associated with adverse cardiovascular events. Little is known about physician risk assessment, prevalence of coronary artery disease (CAD), cardiac catheterization, and the performance of the atherosclerotic cardiovascular disease (ASCVD) risk score in patients with NCVD.

methodsRetrospective analysis of outpatients with angina and no known CAD from the PROMISE trial. NCVD included carotid artery stenosis ≥50%, or history of stroke or peripheral artery disease. Multivariable models of physician estimates of the probability of obstructive CAD, prevalence of non-obstructive and obstructive CAD, referral to cardiac catheterization, and all-cause death/myocardial infarction/unstable angina were performed.

resultsAmong 10,001 patients in the PROMISE trial, 379 (3.8%) patients had NCVD. Only 8.5% of participants with NCVD were categorized as high-risk for obstructive CAD by physicians, though 15.5% (25/161) had obstructive CAD in those randomized to coronary computed tomography (CTA). NCVD was independently associated with non-obstructive (aOR = 1.58; 95% CI 1.18-2.61; P = .006) but not obstructive CAD by CTA. Adjusted referral to cardiac catheterization was similar with and without NCVD (aOR 1.04; 95% CI 0.88-1.94, P = .19). NCVD was associated with an increased risk of all-cause death/MI/UA (aOR 2.03; 95% CI 1.37-3.01, P < .001). There was no interaction between NCVD status and ASCVD risk score.

conclusionsAmong patients with NCVD and angina, NCVD had increased adjusted risks of CAD and adverse outcomes which were not well described by ASCVD risk score and were underrecognized by physicians. Increased awareness and better risk stratification tools for patients with NCVD may be necessary to recognize the associated CV risk and optimize diagnostic testing and therapies.

Indexed as

Cardiovascular DiseasesCoronary Artery DiseaseHeart Disease Risk FactorsHumansRetrospective StudiesTreatment Outcome

Identifiers

PMID34384742
PMCPMC10399724
OpenAlexW3188706503

What OpenQuestion holds

Textmetadata
LicenceTDM
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.