Evidence mapPaperPMID 17699010Full record

ArticleJAMA2007

Diabetes and mortality following acute coronary syndromes.

Sean M Donahoe, Garrick C Stewart, Carolyn H McCabe, Satishkumar Mohanavelu, Sabina A Murphy, Christopher P Cannon, Elliott M Antman

3 registry-linked trialsAbstract read
PubMed Publisher
In one paragraph

Article in JAMA, 2007. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 3 registered trials, which are not on this map. Cited by 244 papers, 6 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
244citing papers in PubMed, 6 pooled it
29.2field-weighted citation impact, top 1% 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.

NCT05037695 phase4unknown statusstarted 2021, after this paper: background citation

SGLT-2 Inhibitors in Prevention of Post-procedural Renal and Cardiovascular Complications aFter PCI Among Patients With Diabetes Mellitus and Coronary Artery Disease: a Prospective, Randomized, Pilot Study (SAFE-PCI)

Ran2021Enrolled40Registered outcomes17Posted comparisons0ConditionsAcute Kidney Injury, Coronary Artery Disease, Diabetes Mellitus, Type 2Armsempagliflozin 25 mg
Open the trial in the graph
NCT01414621 completednot on this mapstarted 2009, after this paper: background citation

IRB #14547: Expression of Angiogenic Factors in Myocardial Tissue in Diabetic and Non-diabetic Patients Undergoing Coronary Bypass Surgery

TypeobservationalSponsorUniversity of VirginiaRan2009 to 2011Enrolled60ConditionsCoronary Artery DiseaseArmsatrial tissue sample
NCT02771808 completednot on this mapstarted 2010, after this paper: background citation

Haptoglobin Polymorphism as a Determinant of Adverse Outcome After Cardiac Surgery in Diabetic Patients

TypeobservationalSponsorUniversity of VirginiaRan2010 to 2015Enrolled83ConditionsCoronary Artery DiseaseArmsbiomarker samples
3 · Its place in the literature

Who cites it

244 citing papers in PubMed, 6 syntheses or guidelines pooled it, 713 citations in OpenAlex.

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184 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

7 authors at 1 institution in 1 country.

Sean M DonahoeDepartment of Medicine, Division of Cardiology, Cornell University Medical Center, New York, New York, USA.
Garrick C Stewart
Carolyn H McCabe
Satishkumar Mohanavelu
Sabina A Murphy
Christopher P Cannon
Elliott M Antman
University Medical Center · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

contextThe worldwide epidemic of diabetes mellitus is increasing the burden of cardiovascular disease, the leading cause of death among persons with diabetes. The independent effect of diabetes on mortality following acute coronary syndromes (ACS) is uncertain.

objectiveTo evaluate the influence of diabetes on mortality following ACS using a large database spanning the full spectrum of ACS. DESIGN, SETTING, AND PATIENTS: A subgroup analysis of patients with diabetes enrolled in randomized clinical trials that evaluated ACS therapies. Patients with ACS in 11 independent Thrombolysis in Myocardial Infarction (TIMI) Study Group clinical trials from 1997 to 2006 were pooled, including 62,036 patients (46,577 with ST-segment elevation myocardial infarction [STEMI] and 15,459 with unstable angina/non-STEMI [UA/NSTEMI]), of whom 10 613 (17.1%) had diabetes. A multivariable model was constructed to adjust for baseline characteristics, aspects of ACS presentation, and treatments for the ACS event.

main outcome measuresMortality at 30 days and 1 year following ACS among patients with diabetes vs patients without diabetes.

resultsMortality at 30 days was significantly higher among patients with diabetes than without diabetes presenting with UA/NSTEMI (2.1% vs 1.1%, P < .001) and STEMI (8.5% vs 5.4%, P < .001). After adjusting for baseline characteristics and features and management of the ACS event, diabetes was independently associated with higher 30-day mortality after UA/NSTEMI (odds ratio [OR], 1.78; 95% confidence interval [CI], 1.24-2.56) or STEMI (OR, 1.40; 95% CI, 1.24-1.57). Diabetes at presentation with ACS was associated with significantly higher mortality 1 year after UA/NSTEMI (hazard ratio [HR], 1.65; 95% CI, 1.30-2.10) or STEMI (HR, 1.22; 95% CI, 1.08-1.38). By 1 year following ACS, patients with diabetes presenting with UA/NSTEMI had a risk of death that approached patients without diabetes presenting with STEMI (7.2% vs 8.1%).

conclusionDespite modern therapies for ACS, diabetes confers a significant adverse prognosis, which highlights the importance of aggressive strategies to manage this high-risk population with unstable ischemic heart disease.

Indexed as

AgedAngina, UnstableDiabetes MellitusFemaleHumansMaleMiddle AgedMyocardial InfarctionPrognosisProportional Hazards ModelsRiskSurvival Analysis

Identifiers

PMID17699010
OpenAlexW2135319342

What Socratic holds

Textmetadata
Read underepoch 390

Registered trials

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 Socratic graph.