Evidence map›Paper›PMID 41906607›Full record

ArticleJACC. Advances2026

Worsening Kidney Function and Cardiovascular Outcomes in Type 2 Diabetes and Atherosclerotic Disease.

Abhinav Sharma, Amir Razaghizad, Susanna R Stevens, Yuliya Lokhnygina, George L Bakris, Jennifer B Green, Darren K McGuire, Renato D Lopes, John B Buse, Paul W Armstrong and 2 more

Abstract read
PubMed Full text at PMC Publisher
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Article in JACC. Advances, 2026. 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
–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

1 citing paper in PubMed.

  1. 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.

Abhinav SharmaDREAM-CV Lab, Research Institute of the McGill University Health Centre (MUHC), Montreal, Quebec, Canada. Electronic address: abhinav.sharma@mcgill.ca.
Amir RazaghizadDREAM-CV Lab, Research Institute of the McGill University Health Centre (MUHC), Montreal, Quebec, Canada.
Susanna R StevensDuke Clinical Research Institute, Duke University School of Medicine, Durham, North Carolina, USA.
Yuliya LokhnyginaDuke Clinical Research Institute, Duke University School of Medicine, Durham, North Carolina, USA.
George L BakrisDepartment of Medicine, University of Chicago Medicine, Chicago, Illinois, USA.
Jennifer B GreenDuke Clinical Research Institute, Duke University School of Medicine, Durham, North Carolina, USA.
Darren K McGuireDivision of Cardiology, Department of Medicine, University of Texas Southwestern Medical Center and Parkland Health and Hospital System, Dallas, Texas, USA.
Renato D LopesDuke Clinical Research Institute, Duke University School of Medicine, Durham, North Carolina, USA.
John B BuseSchool of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
Paul W ArmstrongCanadian VIGOUR Centre, University of Alberta, Edmonton, Alberta, Canada.
Eric D PetersonDivision of Cardiology, Department of Medicine, University of Texas Southwestern Medical Center and Parkland Health and Hospital System, Dallas, Texas, USA.
Rury R HolmanDiabetes Trials Unit, Radcliffe Department of Medicine, University of Oxford, Oxford, United Kingdom.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe bidirectional association between worsening kidney function (WKF) and cardiovascular outcomes in type 2 diabetes (T2D) patients with atherosclerotic cardiovascular disease (ASCVD) is unclear.

objectivesThis study aimed to evaluate the bidirectional association between: 1) nonfatal cardiovascular events and WKF; and 2) severe hypoglycemia and WKF.

methodsWe analyzed data from TECOS (Trial Evaluating Cardiovascular Outcomes with Sitagliptin), enrolling 14,671 patients with T2D and ASCVD randomized to sitagliptin or placebo. The primary outcome was a 4-component major adverse cardiovascular event (MACE4) comprising nonfatal myocardial infarction, stroke, cardiovascular death, or unstable angina hospitalization. We also examined hospitalization for heart failure (hHF). WKF was defined as a glomerular filtration rate decline of ≥40% (per the Modification of Diet in Renal Disease formula) or initiation of renal replacement therapy. Cox proportional hazards models assessed associations between WKF and subsequent MACE4 and hHF.

resultsOver a median 3-year follow-up, 1,030 (7.0%) experienced WKF. Overall, WKF risk increased after nonfatal myocardial infarction, stroke, or unstable angina (adjusted HR [HRadj]: 2.0; 95% CI: 1.6-2.5) and was higher after hHF (HRadj: 6.1; 95% CI: 4.8-7.9). Median estimated glomerular filtration rate declines before MACE4 and hHF were -3.8% (IQR: -17.4, 9.4) and -9.2% (IQR: -22.7, 6.6), respectively. WKF was associated with increased risks of MACE4 (HRadj: 1.9; 95% CI: 1.5-2.4), hHF (HRadj: 3.2; 95% CI: 2.2-4.6), and severe hypoglycemia (HRadj: 2.8; 95% CI: 1.8-4.4).

conclusionsIn patients with T2D and ASCVD, WKF is common and linked to adverse cardiovascular outcomes and severe hypoglycemia, highlighting the need for early cardiorenal therapies.

Indexed as

cardiovascular diseasechronic kidney diseaseheart failuretype 2 diabetes

Identifiers

PMID41906607
PMCPMC13352044

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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.