Evidence map›Paper›PMID 36317424›Full record

ArticleClinical cardiology2022

Multimorbidity, functional impairment, and mortality in older patients stable after prior acute myocardial infarction: Insights from the TIGRIS registry.

Akshay Bagai, Faeez M Ali, John Gregson, Karen P Alexander, Mauricio G Cohen, Karolina Andersson Sundell, Tabassome Simon, Dirk Westermann, Satoshi Yasuda, David Brieger and 4 more

Registry-linked trialAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Clinical cardiology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT01866904 (TIGRIS), which is not on this map. Cited by 7 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed, 2 pooled it
–field-weighted citation impact
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.

NCT01866904 terminatednot on this map

TIGRIS: Long-Term rIsk, Clinical manaGement and Healthcare Resource Utilization of Stable Coronary Artery dISease in Post Myocardial Infarction Patients

TypeobservationalSponsorAstraZenecaRan2013 to 2017Enrolled9,284ConditionsStable Coronary Artery Disease (CAD), Myocardial Infarction
3 · Its place in the literature

Who cites it

7 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Article
  4. Article
  5. Review
  6. Observational
  7. Article
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

14 authors.

Akshay BagaiTerrence Donnelly Heart Center, St. Michael's Hospital, University of Toronto, Toronto, Ontario, Canada.ORCID https://orcid.org/0000-0002-0106-1839
Faeez M AliTerrence Donnelly Heart Center, St. Michael's Hospital, University of Toronto, Toronto, Ontario, Canada.
John GregsonDepartment of Medical Statistics, London School of Hygiene and Tropical Medicine, London, UK.
Karen P AlexanderDuke Clinical Research Institute, Duke University School of Medicine, Durham, North Carolina, USA.
Mauricio G CohenUniversity of Miami Miller School of Medicine, Miami, Florida, USA.
Karolina Andersson SundellBiopharmaceuticals Medical, AstraZeneca, Gothenburg, Sweden.
Tabassome SimonDepartment of Clinical Pharmacology and Clinical Research Platform of East of Paris, Assistance Publique-Hopitaux de Paris, Paris, France.
Dirk WestermannDepartment of Cardiology and Angiology, Medical Center, University of Freiburg, Freiburg im Breisgau, Germany.
Satoshi YasudaDepartment of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan.
David BriegerCardiology Department, Concord Hospital, Sydney, Australia.ORCID http://orcid.org/0000-0001-6115-0326
Shaun G GoodmanTerrence Donnelly Heart Center, St. Michael's Hospital, University of Toronto, Toronto, Ontario, Canada.
Jose C NicolauInstituto do Coracao (InCor), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil.
Christopher B GrangerCardiac Care Unit, Duke University Medical Center, Durham, North Carolina, USA.
Stuart PocockDepartment of Medical Statistics, London School of Hygiene and Tropical Medicine, London, UK.ORCID http://orcid.org/0000-0003-2212-4007

Funding

AstraZeneca
6 · The paper itself

Abstract

backgroundData on the association of multimorbidity and functional impairment with cardiovascular (CV) and non-CV outcomes among older myocardial infarction (MI) patients are limited. HYPOTHESIS: Multimorbidity and functional impairment among older MI patients are associated with CV and non-CV mortality.

methodsPatients aged ≥65 years, 1-3 years post-MI, and enrolled between June 2013 and Novemeber 2014 from 349 sites in 25 countries in the global TIGRIS registry were categorized by age, number of comorbidities, and presence and degree of functional impairment. Functional impairment was calculated using five-dimension EuroQol based on three domains-mobility, self-care, and usual activities. The association between age, number of comorbid conditions, and degree of functional impairment with 2-year incidence of CV and non-CV death was evaluated using Poisson regression analysis.

resultsOlder age was associated with higher number of comorbidities and functional impairment; after adjustment, increasing age was significantly associated with non-CV mortality (p = .03) but not CV mortality (p = .38). Greater functional impairment was associated with a higher rate and relatively equal magnitude risk of CV (rate ratios [RR] 1.52, 95% confidence intervals [CI]: 1.29-1.79, per one-step increase) and non-CV mortality (RR 1.42, 95% CI: 1.17-1.73). Multimorbidity was more strongly associated with CV mortality (RR 1.52, 95% CI: 1.38-1.67, per additional comorbidity) versus non-CV mortality (RR 1.29, 95% CI: 1.14-1.47, per additional comorbidity).

conclusionsMultimorbidity and functional impairment are prevalent among older post-MI patients and are associated with increased CV and non-CV mortality. These findings highlight the importance of considering comorbid conditions and functional impairment as predictors of risk for adverse outcomes and aspects of medical decision making. Clinical Trial Registration: NCT01866904.

Indexed as

MultimorbidityMyocardial InfarctionAgedComorbidityHumansIncidenceRegistriesAcute coronary syndromescomorbiditiesfrailtyfunctional impairmentmultimorbiditymyocardial infarctionolder ageoutcomesrehabilitationstroke

Identifiers

PMID36317424
PMCPMC9748748

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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.