Evidence mapPaperPMID 33616877Full record

ArticleInternal and emergency medicine2021

Ischemic and bleeding risk by type 2 diabetes clusters in patients with acute coronary syndrome.

Ilaria Cavallari, Ernesto Maddaloni, Felice Gragnano, Giuseppe Patti, Emilia Antonucci, Paolo Calabrò, Plinio Cirillo, Paolo Gresele, Gualtiero Palareti, Vittorio Pengo and 3 more

Abstract readMulticenter Study
PubMed Publisher
In one paragraph

Article in Internal and emergency medicine, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
2.0field-weighted citation impact, top 12% 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

6 citing papers in PubMed, 15 citations in OpenAlex.

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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

13 authors at 8 institutions in 2 countries.

Ilaria CavallariDepartment of Medicine, Unit of Cardiovascular Sciences, Campus Bio-Medico University of Rome, Rome, Italy.
Ernesto MaddaloniExperimental Medicine Department, Sapienza University of Rome, Rome, Italy.
Felice GragnanoDivision of Cardiology, Department of Translational Medicine, University of Campania "Luigi Vanvitelli", Caserta, Italy.
Giuseppe PattiChair of Cardiology, Department of Translational Medicine, University of Eastern Piedmont, Maggiore Della Carità Hospital, Via Solaroli, 17, 28100, Novara, Italy. giuseppe.patti@uniupo.it.ORCID 0000-0002-5404-3968
Emilia AntonucciArianna Anticoagulazione Foundation, Bologna, Italy.
Paolo CalabròDivision of Cardiology, Department of Translational Medicine, University of Campania "Luigi Vanvitelli", Caserta, Italy.
Plinio CirilloDivision of Cardiology, Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy.
Paolo GreseleDepartment of Medicine, Section of Internal and Cardiovascular Medicine, University of Perugia, Perugia, Italy.
Gualtiero PalaretiArianna Anticoagulazione Foundation, Bologna, Italy.
Vittorio PengoDepartment of Cardo-Thoracic-Vascular Sciences and Public Health, University of Padova, Padova, Italy.
Pasquale PignatelliDepartment of Clinical Internal Anesthesiologic and Cardiovascular Sciences, Sapienza University of Rome, Rome, Italy.
Rossella MarcucciDepartment of Experimental and Clinical Medicine, Center for Atherothrombotic Diseases, University of Florence, Florence, Italy.
START-ANTIPLATELET collaborators
Sapienza University of Rome · ITUniversity of Campania "Luigi Vanvitelli" · ITUniversity of Padua · ITUniversità Campus Bio-Medico · ITUniversità degli Studi del Piemonte Orientale “Amedeo Avogadro” · ITUniversity of Florence · ITUniversity of Naples Federico II · ITUniversity of Perugia · IT

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

The risk of ischemic events carried by different clusters of type 2 diabetes mellitus (DM) in the setting of secondary prevention is not definite and the association between DM and bleeding complications is controversial. We explored these issues in the START-ANTIPLATELET, a multicenter Italian registry including acute coronary syndrome (ACS) patients. Study outcome was 1-year incidence of the net composite endpoint including major adverse cardiovascular events (MACE) or any bleeding and its individual components across different DM strata (no DM, DM with or without insulin). Out of 951 patients, 20.0% had diabetes not on insulin and 2.5% had diabetes on insulin. The rate of the net composite endpoint was highest in patients receiving insulin (39.4 per 100 person-years vs 11.7 in diabetic patients not on insulin vs 14.0 in those without DM; p = 0.007). In DM, the higher risk of MACE was regardless of insulin use (p = 0.36). Conversely, the increase in bleeding complications was limited to patients on insulin (Hazard Ratio 2.31, 95% CI 0.93-5.71 vs no DM; p = 0.0105 across DM strata). On top of aspirin, the rates of the net composite endpoint were similar with ticagrelor/prasugrel or clopidogrel irrespective of DM status (p for interaction 0.63). In conclusion, in ACS patients, type 2 DM enhances the risk of MACE regardless of the DM cluster, whereas the propensity to bleeding related to DM seems confined to insulin-treated patients.

Indexed as

Acute Coronary SyndromeAgedDiabetes Mellitus, Type 2FemaleHemorrhageHumansIncidenceItalyMaleMiddle AgedProportional Hazards ModelsProspective StudiesRegistriesRisk FactorsAcute coronary syndromesBleedingDiabetesInsulinMajor cardiovascular events

Identifiers

PMID33616877
OpenAlexW3132657645

What Socratic holds

Textmetadata
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.