Evidence mapPaperPMID 25458644Full record

Trial reportAmerican heart journal2014

Pioglitazone for secondary prevention after ischemic stroke and transient ischemic attack: rationale and design of the Insulin Resistance Intervention after Stroke Trial.

Catherine M Viscoli, Lawrence M Brass, Antonio Carolei, Robin Conwit, Gary A Ford, Karen L Furie, Mark Gorman, Peter D Guarino, Silvio E Inzucchi, Anne M Lovejoy and 9 more

Registry-linked trialAbstract readMulticenter StudyRandomized Controlled Trial
In one paragraph

Trial report in American heart journal, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT00091949 (Insulin Resistance Intervention After Stroke), which is not on this map. Cited by 26 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
26citing 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.

NCT00091949 phase3completednot on this map

Insulin Resistance Intervention After Stroke (IRIS) Trial

TypeinterventionalSponsorYale UniversityRan2005 to 2015Enrolled3,876ConditionsStroke, Myocardial Infarction, DiabetesArmspioglitazone, placebo
3 · Its place in the literature

Who cites it

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

  1. Pooled it
  2. Pooled it
  3. Trial
  4. Trial
  5. Trial
  6. Pioglitazone and Risk for Bone Fracture: Safety Data From a Randomized Clinical Trial.The Journal of clinical endocrinology and metabolism · 2017
    Trial
  7. Trial
  8. Trial
  9. Pioglitazone after Ischemic Stroke or Transient Ischemic Attack.The New England journal of medicine · 2016 · on this map
    Trial
  10. Article
  11. Review
  12. Post-stroke cognitive impairment and the risk of stroke recurrence and death in patients with insulin resistance.Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association · 2022
    Article
  13. Peripheral Organ Injury After Stroke.Frontiers in immunology · 2022
    Review
  14. Review
  15. Review
  16. Article
  17. Article
  18. Insulin resistance in ischemic stroke.Metabolic brain disease · 2017
    Review
  19. Review
  20. 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

19 authors.

Catherine M ViscoliYale University School of Medicine, New Haven, CT. Electronic address: catherine.viscoli@yale.edu.
Lawrence M BrassYale University School of Medicine, New Haven, CT.
Antonio CaroleiUniversity of L'Aquila, L'Aquila, Italy.
Robin ConwitNational Institute of Neurological Disorders and Stroke, Bethesda, MD.
Gary A FordOxford University, Oxford, United Kingdom.
Karen L FurieAlpert Medical School of Brown University, Providence, RI.
Mark GormanUniversity of Vermont School of Medicine, Burlington, VT.
Peter D GuarinoCooperative Studies Program Coordinating Center, VA Connecticut Healthcare System, West Haven, CT; Yale School of Public Health, New Haven, CT.
Silvio E InzucchiYale University School of Medicine, New Haven, CT.
Anne M LovejoyYale University School of Medicine, New Haven, CT.
Mark W ParsonsUniversity of Newcastle, Newcastle, Australia.
Peter N PeduzziCooperative Studies Program Coordinating Center, VA Connecticut Healthcare System, West Haven, CT; Yale School of Public Health, New Haven, CT.
Peter A RinglebUniversity of Heidelberg, Heidelberg, Germany.
Gregory G SchwartzVA Medical Center and University of Colorado School of Medicine, Denver, CO.
J David SpenceUniversity of Western Ontario, London, Ontario, Canada.
David TanneTel Aviv University, Tel Aviv, Israel.
Lawrence H YoungYale University School of Medicine, New Haven, CT.
Walter N KernanYale University School of Medicine, New Haven, CT.
IRIS Trial investigators

Funding

Insulin Resistance Intervention after Stroke TrialU01NS044876 · YALE UNIVERSITY · 2004 to 2005
$12.9M
NCATS NIH HHS UL1 TR000142NCATS NIH HHS UL1 TR000439NINDS NIH HHS U01 NS044876
6 · The paper itself

Abstract

backgroundRecurrent vascular events remain a major source of morbidity and mortality after stroke or transient ischemic attack (TIA). The IRIS Trial is evaluating an approach to secondary prevention based on the established association between insulin resistance and increased risk for ischemic vascular events. Specifically, IRIS will test the effectiveness of pioglitazone, an insulin-sensitizing drug of the thiazolidinedione class, for reducing the risk for stroke and myocardial infarction (MI) among insulin resistant, nondiabetic patients with a recent ischemic stroke or TIA.

designEligible patients for IRIS must have had insulin resistance defined by a Homeostasis Model Assessment-Insulin Resistance > 3.0 without meeting criteria for diabetes. Within 6 months of the index stroke or TIA, patients were randomly assigned to pioglitazone (titrated from 15 to 45 mg/d) or matching placebo and followed for up to 5 years. The primary outcome is time to stroke or MI. Secondary outcomes include time to stroke alone, acute coronary syndrome, diabetes, cognitive decline, and all-cause mortality. Enrollment of 3,876 participants from 179 sites in 7 countries was completed in January 2013. Participant follow-up will continue until July 2015. SUMMARY: The IRIS Trial will determine whether treatment with pioglitazone improves cardiovascular outcomes of nondiabetic, insulin-resistant patients with stroke or TIA. Results are expected in early 2016.

Indexed as

Insulin ResistanceIschemic Attack, TransientStrokeAdultCognition DisordersDose-Response Relationship, DrugDouble-Blind MethodFemaleHumansHypoglycemic AgentsMaleMiddle AgedMyocardial InfarctionPatient Outcome AssessmentPioglitazoneRisk AssessmentHypoglycemic AgentsPioglitazoneThiazolidinediones

Identifiers

PMID25458644
PMCPMC4254508

What Socratic holds

Textmetadata
LicenceTDM
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.