Evidence mapPaperPMID 30165984Full record

Trial reportJournal of the American College of Cardiology2018

Cardiac Troponin I and Cardiovascular Risk in Patients With Chronic Obstructive Pulmonary Disease.

Philip D Adamson, Julie A Anderson, Robert D Brook, Peter M A Calverley, Bartolome R Celli, Nicholas J Cowans, Courtney Crim, Ian J Dixon, Fernando J Martinez, David E Newby and 3 more

Erratum issued Registry-linked trialOpen access · hybridAbstract readMulticenter StudyRandomized Controlled Trial
In one paragraph

Trial report in Journal of the American College of Cardiology, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. It is linked to trial NCT01313676 (A Clinical Outcomes Study to Compare the Effect of Fluticasone Furoate/Vilanterol Inhalation Powder 100/25mcg With Placebo on Survival in Subjects With Moderate Chronic Obstructive Pulmonary Disease), which is not on this map. Cited by 36 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
36citing papers in PubMed, 1 pooled it
7.5field-weighted citation impact, top 2% 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.

NCT01313676 phase3completednot on this map

A Clinical Outcomes Study to Compare the Effect of Fluticasone Furoate/Vilanterol Inhalation Powder 100/25mcg With Placebo on Survival in Subjects With Moderate Chronic Obstructive Pulmonary Disease (COPD) and a History of or at Increased Risk for Cardiovascular Disease

TypeinterventionalSponsorGlaxoSmithKlineRan2011 to 2015Enrolled16,568ConditionsPulmonary Disease, Chronic ObstructiveArmsfluticasone furoate/vilanterol, fluticasone furoate, vilanterol, Placebo
3 · Its place in the literature

Who cites it

36 citing papers in PubMed, 1 synthesis or guideline pooled it, 68 citations in OpenAlex.

  1. Methods to assess atherosclerotic cardiovascular risk in chronic respiratory diseases: a systematic review.European respiratory review : an official journal of the European Respiratory Society · 2025
    Pooled it
  2. Trial
  3. Trial
  4. Trial
  5. Article
  6. Article
  7. Article
  8. Article
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  10. The role of coronary artery disease in lung transplantation: a propensity-matched analysis.Clinical research in cardiology : official journal of the German Cardiac Society · 2024
    Article
  11. Article
  12. Review
  13. GOLD COPD DOCUMENT 2023: a brief update for practicing cardiologists.Clinical research in cardiology : official journal of the German Cardiac Society · 2024
    Review
  14. Review
  15. Article
  16. Article
  17. Observational
  18. Article
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  20. Review
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

13 authors at 8 institutions in 2 countries.

Philip D AdamsonBritish Heart Foundation Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, United Kingdom.
Julie A AndersonResearch & Development, GSK, Stockley Park, Middlesex, United Kingdom.
Robert D BrookDivision of Cardiovascular Medicine, University of Michigan, Ann Arbor, Michigan.
Peter M A CalverleyDepartment of Medicine, Clinical Sciences Centre, University of Liverpool, University Hospital Aintree, Liverpool, United Kingdom.
Bartolome R CelliPulmonary and Critical Care Division, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.
Nicholas J CowansStatistics and Programming, Veramed, Twickenham, United Kingdom.
Courtney CrimResearch & Development, GSK, Research Triangle Park, North Carolina.
Ian J DixonStatistics and Programming, Veramed, Twickenham, United Kingdom.
Fernando J MartinezJoan and Sanford I. Weill Department of Medicine, Weill Cornell Medicine, New York, New York.
David E NewbyBritish Heart Foundation Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, United Kingdom.
Jørgen VestboDivision of Infection, Immunity and Centre for Respiratory Medicine and Allergy, Manchester Academic Health Science Centre, The University of Manchester and Manchester University NHS Foundation Trust, Manchester, United Kingdom.
Julie C YatesResearch & Development, GSK, Research Triangle Park, North Carolina.
Nicholas L MillsBritish Heart Foundation Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, United Kingdom. Electronic address: nick.mills@ed.ac.uk.
Research Triangle Park Foundation · USUniversity of Edinburgh · GBBritish Heart Foundation · GBCornell University · USHarvard University · USManchester Academic Health Science Centre · GBUniversity of Liverpool · GBUniversity of Michigan–Ann Arbor · US

Funding

British Heart Foundation FS/16/14/32023
6 · The paper itself

Abstract

backgroundPatients with chronic obstructive pulmonary disease (COPD) have increased risk of cardiovascular events.

objectivesThis study evaluated the association between high-sensitivity cardiac troponin I concentration and cardiovascular events in patients with COPD and heightened cardiovascular risk.

methodsIn a double-blind randomized controlled trial, 16,485 patients with COPD and cardiovascular disease or risk factors were randomized to once daily inhaled placebo, fluticasone furoate (100 μg), vilanterol (25 μg), or their combination. Plasma high-sensitivity cardiac troponin I concentrations were measured in a subgroup of 1,599 patients. Outcomes were on-treatment cardiovascular events and COPD exacerbations over a median of 18 months, and cardiovascular death over a median of 27 months.

resultsBaseline plasma cardiac troponin I concentrations were above the limit of detection (1.2 ng/l) in 1,542 (96%) patients. Concentrations were unaffected by inhaled therapies at 3 months (p > 0.05). Compared with the lowest quintile (cardiac troponin <2.3 ng/l), patients in the highest quintile (≥7.7 ng/l) were at greater risk of cardiovascular events (hazard ratio [HR] 3.7; 95% confidence interval [CI]: 1.3 to 10.1; p = 0.012) and cardiovascular death (HR: 20.1; 95% CI: 2.4 to 165.2; p = 0.005) after adjustment for risk factors. By contrast, there were no differences in exacerbations between quintiles (HR: 1.1; 95% CI: 0.8 to 1.5; p = 0.548).

conclusionsIn patients with COPD and heightened cardiovascular risk, plasma cardiac troponin I concentrations are a specific and major indicator of future cardiovascular events and cardiovascular death. Inhaled therapies did not affect cardiac troponin I concentrations consistent with their neutral effect on mortality and cardiovascular outcomes. (Study to Evaluate the Effect of Fluticasone Furoate/Vilanterol on Survival in Subjects With Chronic Obstructive Pulmonary Disease [SUMMIT]; NCT01313676).

Indexed as

AgedAndrostadienesBenzyl AlcoholsBiomarkersBronchodilator AgentsCardiovascular DiseasesChlorobenzenesDouble-Blind MethodFemaleGlucocorticoidsHumansLimit of DetectionMaleMiddle AgedNebulizers and VaporizersProspective StudiesAndrostadienesBenzyl AlcoholsBiomarkersBronchodilator AgentsChlorobenzenesfluticasone furoateGlucocorticoidsTroponin Ivilanterolcardiac troponincardiovascular riskchronic obstructive pulmonary disease

Identifiers

PMID30165984
PMCPMC6119211
OpenAlexW2888890452

What Socratic holds

Textmetadata
LicenceCC BY
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.