Evidence map›Paper›PMID 33413345›Full record

Trial reportCardiovascular diabetology2021

Apabetalone and hospitalization for heart failure in patients following an acute coronary syndrome: a prespecified analysis of the BETonMACE study.

Stephen J Nicholls, Gregory G Schwartz, Kevin A Buhr, Henry N Ginsberg, Jan O Johansson, Kamyar Kalantar-Zadeh, Ewelina Kulikowski, Peter P Toth, Norman Wong, Michael Sweeney and 2 more

Open access · goldAbstract readClinical Trial, Phase IIIMulticenter StudyRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Cardiovascular diabetology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 52 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
52citing papers in PubMed, 1 pooled it
4.5field-weighted citation impact, top 4% 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

52 citing papers in PubMed, 1 synthesis or guideline pooled it, 73 citations in OpenAlex.

  1. Pooled it
  2. Trial
  3. Trial
  4. Cell Type-Specific Roles for BRD4 in Heart Failure.Current cardiology reports · 2026
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  16. Design of New Daunorubicin Derivatives with High Cytotoxic Potential.International journal of molecular sciences · 2025
    Article
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  20. Epigenetics-targeted drugs: current paradigms and future challenges.Signal transduction and targeted therapy · 2024
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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 at 8 institutions in 4 countries.

Stephen J NichollsMonash Cardiovascular Research Centre, Monash University, 246 Clayton Road, Clayton, VIC, 3168, Australia. stephen.nicholls@monash.edu.
Gregory G SchwartzDivision of Cardiology, University of Colorado School of Medicine, Aurora, CO, USA.
Kevin A BuhrStatistical Data Analysis Center, University of Wisconsin-Madison, Madison, WI, USA.
Henry N GinsbergIrving Institute for Clinical and Translational Research, Columbia University, New York, NY, USA.
Jan O JohanssonResverlogix Corporation, Calgary, AB, Canada.
Kamyar Kalantar-ZadehDivision of Nephrology and Hypertension, University of California Irvine, Irvine, USA.
Ewelina KulikowskiResverlogix Corporation, Calgary, AB, Canada.
Peter P TothCGH Medical Center Sterling, Sterling, IL, USA.
Norman WongResverlogix Corporation, Calgary, AB, Canada.
Michael SweeneyResverlogix Corporation, Calgary, AB, Canada.
Kausik K RayImperial Centre for Cardiovascular Disease Prevention, Imperial College, London, UK.
BETonMACE Investigators
Resverlogix (Canada) · CAUniversity of California, Irvine · USUniversity of Wisconsin–Madison · USCGH Medical Center · USImperial College London · GBJohns Hopkins University · USMonash Medical Centre · AUMonash University · AU

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPatients with diabetes and acute coronary syndrome (ACS) are at high risk for subsequent heart failure. Apabetalone is a selective inhibitor of bromodomain and extra-terminal (BET) proteins, epigenetic regulators of gene expression. Preclinical data suggest that apabetalone exerts favorable effects on pathways related to myocardial structure and function and therefore could impact subsequent heart failure events. The effect of apabetalone on heart failure events after an ACS is not currently known.

methodsThe phase 3 BETonMACE trial was a double-blind, randomized comparison of apabetalone versus placebo on the incidence of major adverse cardiovascular events (MACE) in 2425 patients with a recent ACS and diabetes. This prespecified secondary analysis investigated the impact of apabetalone on hospitalization for congestive heart failure, not previously studied.

resultsPatients (age 62 years, 74.4% males, 90% high-intensity statin use, LDL-C 70.3 mg/dL, HDL-C 33.3 mg/dL and HbA1c 7.3%) were followed for an average 26 months. Apabetalone treated patients experienced the nominal finding of a lower rate of first hospitalization for heart failure (2.4% vs. 4.0%, HR 0.59 [95%CI 0.38-0.94], P = 0.03), total number of hospitalizations for heart failure (35 vs. 70, HR 0.47 [95%CI 0.27-0.83], P = 0.01) and the combination of cardiovascular death or hospitalization for heart failure (5.7% vs. 7.8%, HR 0.72 [95%CI 0.53-0.98], P = 0.04).

conclusionApabetalone treatment was associated with fewer hospitalizations for heart failure in patients with type 2 diabetes and recent ACS. Future studies are warranted to define the potential for BET inhibition with apabetalone to prevent heart failure in patients with diabetes and ACS.

Indexed as

Patient AdmissionAcute Coronary SyndromeAgedCardiovascular AgentsDiabetes Mellitus, Type 2Double-Blind MethodFemaleHeart FailureHumansMaleMiddle AgedPatient ReadmissionQuinazolinonesTime FactorsTreatment OutcomeapabetaloneCardiovascular AgentsQuinazolinonesAcute coronary syndromeAtherosclerosisBET inhibitorsCardiovascular diseaseClinical trialDiabetesEpigeneticsHeart failure

Identifiers

PMID33413345
PMCPMC7791841
OpenAlexW3119440126

What Socratic holds

Textmetadata
LicenceCC BY
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.