Evidence map›Paper›PMID 36539800›Full record

SynthesisTrials2022

Sample size requirement in trials that use the composite endpoint major adverse cardiovascular events (MACE): new insights.

Josep Ramon Marsal, Iratxe Urreta-Barallobre, Marimar Ubeda-Carrillo, Dimelza Osorio, Blanca Lumbreras, David Lora, Borja M Fernández-Felix, Gerard Oristrell, Eduard Ródenas-Alesina, Lorena Herrador and 5 more

Abstract readSystematic Review
In one paragraph

Synthesis in Trials, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
–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.

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

5 citing papers in PubMed.

  1. Article
  2. Article
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  5. 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

15 authors.

Josep Ramon MarsalCardiovascular Epidemiology and Research Unit, Vall d'Hebron Institut de Recerca (VHIR), Vall d'Hebron Barcelona Hospital Campus, Pg. Vall d'Hebron, 119-129, 08035, Barcelona, Spain.
Iratxe Urreta-BarallobreCIBER Epidemiology and Public Health, Madrid, Spain.
Marimar Ubeda-CarrilloOsakidetza Basque Health Service, Donostialdea Integrated Health Organisation, Donostia University Hospital, Library Service, San Sebastián, Spain.
Dimelza OsorioCIBER Epidemiology and Public Health, Madrid, Spain.
Blanca LumbrerasCIBER Epidemiology and Public Health, Madrid, Spain.
David LoraCIBER Epidemiology and Public Health, Madrid, Spain.
Borja M Fernández-FelixCIBER Epidemiology and Public Health, Madrid, Spain.
Gerard OristrellCardiology Department, Vall d'Hebron University Hospital, Barcelona, Spain.
Eduard Ródenas-AlesinaCardiology Department, Vall d'Hebron University Hospital, Barcelona, Spain.
Lorena HerradorCardiology Department, Vall d'Hebron University Hospital, Barcelona, Spain.
Mónica BallesterosCIBER Epidemiology and Public Health, Madrid, Spain.
Javier ZamoraCIBER Epidemiology and Public Health, Madrid, Spain.
Jose I PijoanCIBER Epidemiology and Public Health, Madrid, Spain.
Aida RiberaCardiovascular Epidemiology and Research Unit, Vall d'Hebron Institut de Recerca (VHIR), Vall d'Hebron Barcelona Hospital Campus, Pg. Vall d'Hebron, 119-129, 08035, Barcelona, Spain. aida.ribera@vhir.org.ORCID http://orcid.org/0000-0002-2604-6328
Ignacio Ferreira-GonzálezCardiovascular Epidemiology and Research Unit, Vall d'Hebron Institut de Recerca (VHIR), Vall d'Hebron Barcelona Hospital Campus, Pg. Vall d'Hebron, 119-129, 08035, Barcelona, Spain. iferreir@vhebron.net.

Funding

Directorate-General for Health and Food Safety P6-2020
6 · The paper itself

Abstract

backgroundThe real impact of the degree of association (DoA) between endpoint components of a composite endpoint (CE) on sample size requirement (SSR) has not been explored. We estimate the impact of the DoA between death and acute myocardial infarction (AMI) on SSR of trials using use the CE of major adverse cardiac events (MACE).

methodsA systematic review and quantitative synthesis of trials that include MACE as the primary outcome through search strategies in MEDLINE and EMBASE electronic databases. We limited to articles published in journals indexed in the first quartile of the Cardiac & Cardiovascular Systems category (Journal Citation Reports, 2015-2020). The authors were contacted to estimate the DoA between death and AMI using joint probability and correlation. We analyzed the SSR variation using the DoA estimated from RCTs.

resultsSixty-three of 134 publications that reported event rates and the therapy effect in all component endpoints were included in the quantitative synthesis. The most frequent combination was death, AMI, and revascularization (n = 20; 31.8%). The correlation between death and AMI, estimated from 5 trials¸ oscillated between - 0.02 and 0.31. SSR varied from 14,602 in the scenario with the strongest correlation to 12,259 in the scenario with the weakest correlation; the relative impact was 16%.

conclusionsThe DoA between death and AMI is highly variable and may lead to a considerable SSR variation in a trial including MACE.

Indexed as

Cardiovascular SystemMyocardial InfarctionHumansSample SizeComposite endpointsCorrelationMACESample size

Identifiers

PMID36539800
PMCPMC9769015

What OpenQuestion holds

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Registered trials

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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.