Evidence map›Paper›PMID 34940843›Full record

ArticleEuropean heart journal. Quality of care & clinical outcomes2022

Real-world management and outcomes of 7 million patients with acute coronary syndrome according to clinical research trial enrolment status: a propensity matched analysis.

Andrija Matetic, Mohamed O Mohamed, Derek J Roberts, Jamal S Rana, M Chadi Alraies, Brijesh Patel, Andrew J Sauer, Carlos Diaz-Arocutipa, Yasar Sattar, Harriette G C Van Spall and 1 more

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In one paragraph

Article in European heart journal. Quality of care & clinical outcomes, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
0.6field-weighted citation impact, top 28% 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

3 citing papers in PubMed, 5 citations in OpenAlex.

  1. Review
  2. Observational
  3. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

11 authors at 8 institutions in 5 countries.

Andrija MateticDepartment of Cardiology, University Hospital of Split, Split, Croatia.ORCID 0000-0001-9272-6906
Mohamed O MohamedKeele Cardiovascular Research Group, Centre for Prognosis Research, Institute for Primary Care and Health Sciences, Keele University, UK.ORCID 0000-0002-9678-5222
Derek J RobertsDivision of Vascular and Endovascular Surgery, Department of Surgery, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada.ORCID 0000-0001-6111-6291
Jamal S RanaDepartment of Cardiology, Kaiser Permanente Northern California, Oakland, CA, USA.
M Chadi AlraiesDivision of Interventional Cardiology, Detroit Medical Center, Detroit, MI, USA.ORCID 0000-0002-7874-4566
Brijesh PatelDivision of Cardiology, West Virginia University School of Medicine, Morgantown, WV, USA.
Andrew J SauerDepartment of Cardiovascular Medicine, University of Kansas School of Medicine, Kansas City, KS, USA.
Carlos Diaz-ArocutipaVicerrectorado de Investigación, Universidad San Ignacio de Loyola, Lima, Peru.ORCID 0000-0002-5101-2832
Yasar SattarDivision of Cardiology, West Virginia University School of Medicine, Morgantown, WV, USA.
Harriette G C Van SpallDepartment of Medicine, McMaster University, Hamilton, ON, Canada.
Mamas A MamasKeele Cardiovascular Research Group, Centre for Prognosis Research, Institute for Primary Care and Health Sciences, Keele University, UK.
Keele University · GBWest Virginia University · USDetroit Medical Center · USKaiser Permanente · USPopulation Health Research Institute · CAUniversidad San Ignacio de Loyola · PEUniversity of Kansas · USUniversity of Ottawa · CA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

aimsWe aimed to determine whether clinical outcomes and invasive care of acute coronary syndrome (ACS) patients participating in trials differed from those of non-participants, particularly including those who were trial eligible. METHODS AND

resultsWe included all hospitalizations with a principal diagnosis of ACS in the US National Inpatient Sample between January 2004 and September 2015, stratified by trial enrolment and eligibility using the International Classification of Diseases, ninth revision. We conducted propensity score matching to investigate the following outcomes: all-cause mortality; major bleeding; stroke; composite of mortality, stroke, and cardiac complications [major adverse cardiovascular and cerebrovascular events (MACCEs)]; coronary angiography (CA); and percutaneous coronary intervention (PCI). A total of 7 091 179 weighted ACS hospitalizations were analysed, including 19 684 (0.3%) trial participants and 7 071 495 non-participants (3 485 514 of whom were trial eligible). Trial participants were more likely to receive CA [Δ% 28.73%, 95% confidence interval (CI) 27.22-30.24, P < 0.001] and PCI (Δ% 27.13%, 95% CI 24.86-29.41, P < 0.001), with decreased mortality (Δ% -3.51%, 95% CI -4.72 to -2.31, P < 0.001), MACCEs (Δ% -3.04%, 95% CI -4.55 to -1.53, P < 0.001), and bleeding (Δ% -0.89%, 95% CI -1.59 to -0.19, P = 0.013) compared with non-participants. After accounting for eligibility, trial participants were more likely to undergo CA (Δ% 22.78%, 95% CI 21.58-23.99, P < 0.001) and PCI (Δ% 23.95%, 95% CI 21.77-26.13, P < 0.001), and had no difference in mortality (Δ% -0.21%, 95% CI -0.65 to 0.24, P = 0.362).

conclusionAmong ACS patients, trial enrolment was associated with significantly greater invasive care and lower mortality than among matched non-participants. Trial participants were more likely to be invasively managed even when compared with eligible non-participants, even though there was no difference in mortality.

Indexed as

Acute Coronary SyndromePercutaneous Coronary InterventionStrokeCoronary AngiographyHemorrhageHumansAcute coronary syndromeManagementOutcomesTrial enrolment

Identifiers

PMID34940843
OpenAlexW4200326507

What OpenQuestion holds

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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.