Evidence map›Paper›PMID 38710952›Full record

Trial reportNature medicine2024

A hierarchical kidney outcome using win statistics in patients with heart failure from the DAPA-HF and DELIVER trials.

Toru Kondo, Pardeep S Jhund, Samvel B Gasparyan, Mingming Yang, Brian L Claggett, Finnian R McCausland, Paolo Tolomeo, Muthiah Vadagunathan, Hiddo J L Heerspink, Scott D Solomon and 1 more

Abstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Nature medicine, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the 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.

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

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

  1. Pooled it
  2. Guideline
  3. Trial
  4. Review
  5. Review
  6. Article
  7. The Win Ratio for Composite Outcomes in Nephrology Clinical Trials.Journal of the American Society of Nephrology : JASN · 2024
    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

11 authors.

Toru KondoBritish Heart Foundation Cardiovascular Research Centre, University of Glasgow, Glasgow, UK.ORCID 0000-0001-6853-7574
Pardeep S JhundBritish Heart Foundation Cardiovascular Research Centre, University of Glasgow, Glasgow, UK.ORCID 0000-0003-4306-5317
Samvel B GasparyanLate-Stage Development, Cardiovascular, Renal, and Metabolism, BioPharmaceuticals R&D, AstraZeneca, Gothenburg, Sweden.ORCID 0000-0002-4797-2208
Mingming YangBritish Heart Foundation Cardiovascular Research Centre, University of Glasgow, Glasgow, UK.ORCID 0000-0003-4484-0979
Brian L ClaggettCardiovascular Division, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
Finnian R McCauslandRenal Division, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
Paolo TolomeoBritish Heart Foundation Cardiovascular Research Centre, University of Glasgow, Glasgow, UK.
Muthiah VadagunathanCardiovascular Division, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
Hiddo J L HeerspinkDepartment of Clinical Pharmacy and Pharmacology, University of Groningen, Groningen, the Netherlands.
Scott D SolomonCardiovascular Division, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.ORCID 0000-0003-3698-9597
John J V McMurrayBritish Heart Foundation Cardiovascular Research Centre, University of Glasgow, Glasgow, UK. john.mcmurray@glasgow.ac.uk.ORCID 0000-0002-6317-3975

Funding

British Heart Foundation RE/18/6/34217
6 · The paper itself

Abstract

Win statistics offer a new approach to the analysis of outcomes in clinical trials, allowing the combination of time-to-event and longitudinal measurements and taking into account the clinical importance of the components of composite outcomes, as well as their relative timing. We examined this approach in a post hoc analysis of two trials that compared dapagliflozin to placebo in patients with heart failure and reduced ejection fraction (DAPA-HF) and mildly reduced or preserved ejection fraction (DELIVER). The effect of dapagliflozin on a hierarchical composite kidney outcome was assessed, including the following: (1) all-cause mortality; (2) end-stage kidney disease; (3) a decline in estimated glomerular filtration rate (eGFR) of ≥57%; (4) a decline in eGFR of ≥50%; (5) a decline in eGFR of ≥40%; and (6) participant-level eGFR slope. For this outcome, the win ratio was 1.10 (95% confidence interval (CI) = 1.06-1.15) in the combined dataset, 1.08 (95% CI = 1.01-1.16) in the DAPA-HF trial and 1.12 (95% CI = 1.05-1.18) in the DELIVER trial; that is, dapagliflozin was superior to placebo in both trials. The benefits of treatment were consistent in participants with and without baseline kidney disease, and with and without type 2 diabetes. In heart failure trials, win statistics may provide the statistical power to evaluate the effect of treatments on kidney as well as cardiovascular outcomes.

Indexed as

Benzhydryl CompoundsGlomerular Filtration RateGlucosidesHeart FailureAgedFemaleHumansKidneyKidney Failure, ChronicMaleMiddle AgedSodium-Glucose Transporter 2 InhibitorsStroke VolumeTreatment OutcomeBenzhydryl CompoundsdapagliflozinGlucosidesSodium-Glucose Transporter 2 Inhibitors

Identifiers

PMID38710952
PMCPMC11108780

What OpenQuestion holds

Textmetadata
LicenceCC BY
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.