Evidence map›Paper›PMID 36656377›Full record

ArticleClinical research in cardiology : official journal of the German Cardiac Society2023

Disconnect between the effects of serelaxin on renal function and outcome in acute heart failure.

I E Beldhuis, J M Ter Maaten, S M Figarska, K Damman, P S Pang, B Greenberg, B A Davison, G Cotter, T Severin, C Gimpelewicz and 5 more

Open access · hybridAbstract read
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In one paragraph

Article in Clinical research in cardiology : official journal of the German Cardiac Society, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
1.2field-weighted citation impact, top 23% 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

1 citing paper in PubMed, 4 citations in OpenAlex.

  1. Trial
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 at 9 institutions in 6 countries.

I E BeldhuisDepartment of Cardiology, University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9713 GZ, Groningen, The Netherlands.ORCID http://orcid.org/0000-0002-3679-168X
J M Ter MaatenDepartment of Cardiology, University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9713 GZ, Groningen, The Netherlands.
S M FigarskaDepartment of Cardiology, University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9713 GZ, Groningen, The Netherlands.
K DammanDepartment of Cardiology, University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9713 GZ, Groningen, The Netherlands.
P S PangDepartment of Emergency Medicine, Indiana University, Indianapolis, IN, USA.
B GreenbergSulpizio Family Cardiovascular Center, University of California San Diego Health, La Jolla, CA, USA.
B A DavisonMomentum Research and Inserm U942 MASCOT, Paris, France.
G CotterMomentum Research and Inserm U942 MASCOT, Paris, France.
T SeverinNovartis Pharma, Basel, Switzerland.
C GimpelewiczNovartis Pharma, Basel, Switzerland.
G M FelkerDuke University School of Medicine and Duke Clinical Research Institute, Durham, NC, USA.
G FilippatosDepartment of Cardiology, Athens University Hospital Attikon, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece.
J R TeerlinkSection of Cardiology, San Francisco Veterans Affairs Medical Center and School of Medicine, University of California, San Francisco, CA, USA.
M MetraCardiology, Department of Medical and Surgical Specialties, Radiologic Sciences, and Public Health, University of Brescia, Brescia, Italy.
A A VoorsDepartment of Cardiology, University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9713 GZ, Groningen, The Netherlands. a.a.voors@umcg.nl.
University Medical Center Groningen · NLInserm · FRNovartis (Switzerland) · CHDuke University · USIndiana University – Purdue University Indianapolis · USNational and Kapodistrian University of Athens · GRSan Francisco VA Medical Center · USUC San Diego Health System · USUniversity of Brescia · IT

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundWe aimed to study whether improvement in renal function by serelaxin in patients who were hospitalized for acute heart failure (HF) might explain any potential effect on clinical outcomes.

methodsWe included 6318 patients from the RELAXin in AHF-2 (RELAX-AHF2) study. Improvement in renal function was defined as a decrease in serum creatinine of ≥ 0.3 mg/dL and ≥ 25%, or increase in estimated glomerular filtration rate of ≥ 25% between baseline and day 2. Worsening renal function (WRF) was defined as the reverse. We performed causal mediation analyses regarding 180-day all-cause mortality (ACM), cardiovascular death (CVD), and hospitalization for HF/renal failure.

resultsImprovement in renal function was more frequently observed with serelaxin when compared with placebo [OR 1.88 (95% CI 1.64-2.15, p < 0.0001)], but was not associated with subsequent clinical outcomes. WRF occurred less frequent with serelaxin [OR 0.70 (95% CI 0.60-0.83, p < 0.0001)] and was associated with increased risk of ACM, worsening HF and the composite of CVD and HF or renal failure hospitalization. Improvement in renal function did not mediate the treatment effect of serelaxin [CVD HR 1.01 (0.99-1.04), ACM HR 1.01 (0.99-1.03), HF/renal failure hospitalization HR 0.99 (0.97-1.00)].

conclusionsDespite the significant improvement in renal function by serelaxin in patients with acute HF, the potential beneficial treatment effect was not mediated by improvement in renal function. These data suggest that improvement in renal function might not be a suitable surrogate marker for potential treatment efficacy in future studies with novel relaxin agents in acute HF. Central illustration. Conceptual model explaining mediation analysis; treatment efficacy of heart failure therapies mediated by renal function.

Indexed as

Heart FailureRelaxinRenal InsufficiencyAcute DiseaseHumansKidneyRecombinant ProteinsTreatment OutcomeVasodilator AgentsRecombinant ProteinsRelaxinserelaxin protein, humanVasodilator AgentsAcute heart failureMediation analysisRenal function changeSerelaxin

Identifiers

PMID36656377
PMCPMC10293419
OpenAlexW4317435252

What OpenQuestion holds

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LicenceCC BY
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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.