Evidence map›Paper›PMID 38224416›Full record

ArticleCardiovascular drugs and therapy2025

Evaluation of Midodrine Utilization in Patients with Cancer and Heart Failure.

Jorge A Irizarry-Caro, Juhee Song, Chase Miller, Shyam Desai, James Going, Jose Fossas-Espinosa, Mariya M Fatakdawala, Abdelrahman Ali, Cezar Iliescu, Nicolas Palaskas and 2 more

Abstract read
PubMed Publisher
In one paragraph

Article in Cardiovascular drugs and therapy, 2025. 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. Review
  2. Article
  3. Article
  4. Article
  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

12 authors.

Jorge A Irizarry-CaroDepartment of Internal Medicine, University of Texas Health Science Center at Houston, Houston, TX, USA.ORCID 0009-0001-6394-2543
Juhee SongDepartment of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Chase MillerDepartment of Internal Medicine, University of Texas Health Science Center at Houston, Houston, TX, USA.
Shyam DesaiDepartment of Internal Medicine, University of Texas Health Science Center at Houston, Houston, TX, USA.
James GoingDepartment of Internal Medicine, University of Texas Health Science Center at Houston, Houston, TX, USA.
Jose Fossas-EspinosaDepartment of Internal Medicine, University of Texas Health Science Center at Houston, Houston, TX, USA.
Mariya M FatakdawalaDepartment of Cardiology, Division of Internal Medicine, University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Unit 1451, Houston, TX, 77030, USA.
Abdelrahman AliDepartment of Cardiology, Division of Internal Medicine, University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Unit 1451, Houston, TX, 77030, USA.
Cezar IliescuDepartment of Cardiology, Division of Internal Medicine, University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Unit 1451, Houston, TX, 77030, USA.
Nicolas PalaskasDepartment of Cardiology, Division of Internal Medicine, University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Unit 1451, Houston, TX, 77030, USA.
Anita DeswalDepartment of Cardiology, Division of Internal Medicine, University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Unit 1451, Houston, TX, 77030, USA.
Efstratios KoutroumpakisDepartment of Cardiology, Division of Internal Medicine, University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Unit 1451, Houston, TX, 77030, USA. EKoutroumpakis@mdanderson.org.

Funding

Tumor Evolution and Metastasis ProgramP30CA016672 · NCI · UNIVERSITY OF TX MD ANDERSON CAN CTR · PI Fabien Delerue · 1985 to 2026
$290.8M
NCI NIH HHS P30 CA016672
6 · The paper itself

Abstract

purposeThe purpose of this study was to evaluate safety and cardiovascular outcomes as well as overall survival of cancer patients with concomitant heart failure (HF) treated with midodrine for hypotension.

methodsAdult patients diagnosed with cancer and HF who were treated with midodrine at a tertiary cancer center from 03/2013 to 08/2021 were identified. Demographic and clinical parameters were collected retrospectively.

resultsA total of 85 patients were included with a median age of 68 years (IQR: 60, 74; 33% female and 85% White). Of those, 31% had HFpEF (EF ≥ 50%), 42% HF with mildly reduced EF (HFmrEF; EF 41-49%), and 27% HFrEF (EF ≤ 40%). The most common indication for midodrine use was orthostatic hypotension (49%). Midodrine was continued for at least one month in 57% of the patients. Supine hypertension was the only side effect reported in 6% of patients. No statistically significant changes in NYHA class, guideline-directed medical therapy, cardiac biomarkers (NT-proBNP or troponin T), echocardiographic findings or cardiovascular hospitalizations were observed between patients who continued treatment with midodrine compared to those who stopped using midodrine over a median follow-up of 38 months. In the multivariable cox regression analysis, continuation of midodrine, compared to discontinuation, and use of midodrine for orthostatic hypotension, as opposed to other causes of hypotension, were not associated with an increased risk of mortality (HR 0.41, 95% CI 0.24-0.69, p < .0001; HR 0.34, 95% CI 0.18-0.64, p < .001, respectively). In contrast, elevated creatinine (> 1.3 for males and > 1.1 for females) was associated with an increased risk of mortality (HR 1.83, 95% CI 1.07-3.14). LVEF was not significantly associated with lower or higher risk of mortality.

conclusionsIn our study, midodrine use in patients with cancer and HF was not associated with significant adverse effects, worse cardiovascular outcomes, or increased risk of mortality. Larger, prospective studies are needed to confirm these findings.

Indexed as

Adrenergic alpha-1 Receptor AgonistsHeart FailureHypotension, OrthostaticMidodrineNeoplasmsAgedFemaleHumansMaleMiddle AgedRetrospective StudiesRisk FactorsTime FactorsTreatment OutcomeAdrenergic alpha-1 Receptor AgonistsMidodrineCancerGuideline-directed medical therapyHeart failureHypotensionMidodrine

Identifiers

PMID38224416

What OpenQuestion holds

Textmetadata
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.