Evidence map›Paper›PMID 32293090›Full record

SynthesisEuropean journal of heart failure2020

Trends in prevalence of comorbidities in heart failure clinical trials.

Muhammad Shahzeb Khan, Ayman Samman Tahhan, Muthiah Vaduganathan, Stephen J Greene, Alaaeddin Alrohaibani, Stefan D Anker, Orly Vardeny, Gregg C Fonarow, Javed Butler

Open access · greenAbstract readSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in European journal of heart failure, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 79 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
79citing papers in PubMed, 2 pooled it
10.0field-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.

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

79 citing papers in PubMed, 2 syntheses or guidelines pooled it, 138 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Trial
  4. Trial
  5. Review
  6. Article
  7. Prevalence and prognosis of multimorbidity in heart failure with mildly reduced ejection fraction.Clinical research in cardiology : official journal of the German Cardiac Society · 2026
    Article
  8. Closing the leak: why should interventional closure of paravalvular leaks deserve more attention?Clinical research in cardiology : official journal of the German Cardiac Society · 2026
    Article
  9. Article
  10. Review
  11. Assessing left atrial appendage sealing after interventional closure: how complete is complete?Clinical research in cardiology : official journal of the German Cardiac Society · 2026
    Article
  12. Article
  13. Article
  14. Article
  15. Review
  16. Comorbidity patterns and mortality in HFpEF: A retrospective longitudinal cohort study.International journal of cardiology. Cardiovascular risk and prevention · 2025
    Article
  17. Observational
  18. Review
  19. Article
  20. Article

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

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

9 authors at 8 institutions in 2 countries.

Muhammad Shahzeb KhanDepartment of Medicine, Cook County Hospital, Chicago, IL, USA.
Ayman Samman TahhanDivision of Cardiology, Department of Medicine, Emory University School of Medicine, Atlanta, GA, USA.
Muthiah VaduganathanBrigham and Women's Hospital Heart and Vascular Center and Harvard Medical School, Boston, MA, USA.
Stephen J GreeneDuke Clinical Research Institute and Division of Cardiology, Duke University Medical Center, Durham, NC, USA.
Alaaeddin AlrohaibaniDepartment of Medicine, Cook County Hospital, Chicago, IL, USA.
Stefan D AnkerDepartment of Cardiology (CVK); and Berlin Institute of Health Center for Regenerative Therapies (BCRT), |German Centre for Cardiovascular Research (DZHK) partner site Berlin; Charité Universitätsmedizin Berlin, Berlin, Germany.
Orly VardenyUniversity of Minnesota, Minneapolis, MN, USA.
Gregg C FonarowAhmanson-UCLA Cardiomyopathy Center, University of California Los Angeles, Los Angeles, CA, USA.
Javed ButlerDepartment of Medicine, University of Mississippi, Jackson, MS, USA.
John H. Stroger, Jr. Hospital of Cook County · USBrigham and Women's Hospital · USCharité - Universitätsmedizin Berlin · DEDuke Medical Center · USEmory University · USUniversity of California, Los Angeles · USUniversity of Minnesota · USUniversity of Mississippi · US

Funding

The Harvard Clinical and Translational Science CenterUL1TR002541 · NCATS · HARVARD MEDICAL SCHOOL · PI NADLER, LEE MARSHALL · 2018 to 2022
$93.0M
Postdoctoral Training in Cardiovascular Clinical ResearchT32HL069749 · NHLBI · DUKE UNIVERSITY · PI MARK, DANIEL B · 2003 to 2023
$6.7M
The role of the renin-angiotensin-endothelial pathway in ADRF1AG051633 · NIA · EMORY UNIVERSITY · PI HAJJAR, IHAB M, QUYYUMI, ARSHED A · 2015 to 2017
$6.0M
NCATS NIH HHS UL1 TR002541NHLBI NIH HHS T32 HL069749NIA NIH HHS RF1 AG051633
6 · The paper itself

Abstract

aimsThe primary objective of this systematic review was to estimate the prevalence and temporal changes in chronic comorbid conditions reported in heart failure (HF) clinical trials. METHODS AND

resultsWe searched MEDLINE for HF trials enrolling more than 400 patients published between 2001 and 2016.Trials were divided into HF with reduced ejection fraction (HFrEF), HF with preserved ejection fraction (HFpEF), or trials enrolling regardless of ejection fraction. The prevalence of baseline chronic comorbid conditions was categorized according to the algorithm proposed by the Chronic Conditions Data Warehouse, which is used to analyse Medicare data. To test for a trend in the prevalence of comorbid conditions, linear regression models were used to evaluate temporal trends in prevalence of comorbidities. Overall, 118 clinical trials enrolling a cumulative total of 215 508 patients were included. Across all comorbidities examined, data were reported in a mean of 35% of trials, without significant improvement during the study period. Reporting of comorbidities was more common in HFrEF trials (51%) compared with HFpEF trials (27%). Among trials reporting data, hypertension (63%), ischaemic heart disease (44%), hyperlipidaemia (48%), diabetes (33%), chronic kidney disease (25%) and atrial fibrillation (25%) were the major comorbidities. The prevalence of comorbidities including hypertension, atrial fibrillation and chronic kidney disease increased over time while the prevalence of smoking decreased in HFrEF trials.

conclusionMany HF trials do not report baseline comorbidities. A more rigorous, systematic, and standardized framework needs to be adopted for future clinical trials to ensure adequate comorbidity reporting and improve recruitment of multi-morbid HF patients.

Indexed as

Heart FailureChronic DiseaseClinical Trials as TopicComorbidityHumansPrevalencePrognosisUnited StatesClinical trialsComorbiditiesHeart failureTrends

Identifiers

PMID32293090
PMCPMC7906002
OpenAlexW3016159813

What Socratic holds

Textmetadata
LicenceTDM
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 Socratic graph.