Evidence map›Paper›PMID 34655282›Full record

ReviewESC heart failure2021

'Time is prognosis' in heart failure: time-to-treatment initiation as a modifiable risk factor.

Amr Abdin, Stefan D Anker, Javed Butler, Andrew J Stewart Coats, Ingrid Kindermann, Mitja Lainscak, Lars H Lund, Marco Metra, Wilfried Mullens, Giuseppe Rosano and 3 more

2 registry-linked trialsOpen access · goldAbstract readReview
In one paragraph

Review in ESC heart failure, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 78 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
78citing papers in PubMed, 1 pooled it
11.1field-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.

NCT07547878 phase4not yet recruitingstarted 2026, after this paper: background citation

A Pilot Randomized Clinical Trial to Assess Feasibility, Safety, and Efficacy of Rapid, Simultaneous Therapy Initiation in Chronic Kidney Disease and Type 2 Diabetes: RAPID-CKD

Ran2026Enrolled64Registered outcomes18Posted comparisons0ConditionsChronic Kidney Disease, Type 2 DiabetesArmsAccupril, Aceon, Altace, Atacand, Avapro
Open the trial in the graph
NCT07339007 enrolling by invitationnot on this mapstarted 2023, after this paper: background citation

Observational Study to Validate a Family Physician Echocardiography Training Programme

Typeobservational_patient_registrySponsorSocietat Catalana de Medicina Familiar i Comunitària, Assoc. (CAMFiC)Ran2023 to 2027Enrolled500ConditionsHeart Failure, Valvular Heart Diseases, Atrial Fibrillation (AF), Arterial HypertensionArmsCohort of GPs: Training program, Cohort of patients
3 · Its place in the literature

Who cites it

78 citing papers in PubMed, 1 synthesis or guideline pooled it, 115 citations in OpenAlex.

  1. Pooled it
  2. Incident heart failure in patients with screening-detected atrial fibrillation: a post hoc analysis of the STROKESTOP and STROKESTOP II studies.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2026
    Trial
  3. Trial
  4. Trial
  5. Longitudinal Trajectories of Hospitalizations in U.S. Older Adults with Heart Failure.The journals of gerontology. Series A, Biological sciences and medical sciences · 2026
    Article
  6. Article
  7. HLM Staging and Treatment Benefit of SGLT2i Across Heart Failure Severity.Journal of cardiovascular development and disease · 2026
    Article
  8. Review
  9. Article
  10. Article
  11. Article
  12. Article
  13. Review
  14. Review
  15. ANMCO position paper: ANMCO general assembly 2024-the role of the cardiologist in the management of cardiovascular chronicity.European heart journal supplements : journal of the European Society of Cardiology · 2026
    Article
  16. Article
  17. Article
  18. Review
  19. Article
  20. Article

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

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 9 institutions in 7 countries.

Amr AbdinKlinik für Innere Medizin III-Kardiologie, Angiologie und Internistische Intensivmedizin, Universitätsklinikum des Saarlandes, Kirrberger Strasse 100, Homburg, 66421, Germany.
Stefan D AnkerDepartment of Cardiology & Berlin Institute of Health Center for Regenerative Therapies (BCRT), German Centre for Cardiovascular Research (DZHK), partner site Berlin, Charité-Universitätsmedizin Berlin (Campus CVK), Berlin, Germany.
Javed ButlerDepartment of Medicine, University of Mississippi Medical Center, Jackson, MS, USA.
Andrew J Stewart CoatsUniversity of Warwick, Coventry, UK.
Ingrid KindermannKlinik für Innere Medizin III-Kardiologie, Angiologie und Internistische Intensivmedizin, Universitätsklinikum des Saarlandes, Kirrberger Strasse 100, Homburg, 66421, Germany.
Mitja LainscakDivision of Cardiology, General Hospital Murska Sobota, Murska Sobota, Slovenia.
Lars H LundDivision of Cardiology, Department of Medicine, Karolinska Institutet, Stockholm, Sweden.
Marco MetraDepartment of Cardiology, University and Civil Hospitals of Brescia, Brescia, Italy.
Wilfried MullensDepartment of Cardiology, Ziekenhuis Oost-Limburg (ZOL), Genk, Belgium.
Giuseppe RosanoDepartment of Medical Sciences, IRCCS San Raffaele Pisana, Rome, Italy.
Jonathan SlawikKlinik für Innere Medizin III-Kardiologie, Angiologie und Internistische Intensivmedizin, Universitätsklinikum des Saarlandes, Kirrberger Strasse 100, Homburg, 66421, Germany.
Jan WintrichKlinik für Innere Medizin III-Kardiologie, Angiologie und Internistische Intensivmedizin, Universitätsklinikum des Saarlandes, Kirrberger Strasse 100, Homburg, 66421, Germany.
Michael BöhmKlinik für Innere Medizin III-Kardiologie, Angiologie und Internistische Intensivmedizin, Universitätsklinikum des Saarlandes, Kirrberger Strasse 100, Homburg, 66421, Germany.
Universitätsklinikum des Saarlandes · DEBrescia University · USCharité - Universitätsmedizin Berlin · DEKarolinska Institutet · SEPomurski muzej Murska Sobota · SIUniversity of Mississippi Medical Center · USUniversity of Warwick · GBVita-Salute San Raffaele University · ITZiekenhuis Oost-Limburg · BE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

In heart failure (HF), acute decompensation can occur quickly and unexpectedly because of worsening of chronic HF or to new-onset HF diagnosed for the first time ('de novo'). Patients presenting with acute HF (AHF) have a poor prognosis comparable with those with acute myocardial infarction, and any delay of treatment initiation is associated with worse outcomes. Recent HF guidelines and recommendations have highlighted the importance of a timely diagnosis and immediate treatment for patients presenting with AHF to decrease disease progression and improve prognosis. However, based on the available data, there is still uncertainty regarding the optimal 'time-to-treatment' effect in AHF. Furthermore, the immediate post-worsening HF period plays an important role in clinical outcomes in HF patients after hospitalization and is known as the 'vulnerable phase' characterized by high risk of readmission and early death. Early and intensive treatment for HF patients in the 'vulnerable phase' might be associated with lower rates of early readmission and mortality. Additionally, in the chronic stable HF outpatient, treatments are often delayed or not initiated when symptoms are stable, ignoring the risk for adverse outcomes such as sudden death. Consequently, there is a dire need to better identify HF patients during hospitalization and after discharge and treating them adequately to improve their prognosis. HF is an urgent clinical scenario along all its stages and disease conditions. Therefore, time plays a significant role throughout the entire patient's journey. Therapy should be optimized as soon as possible, because this is beneficial regardless of severity or duration of HF. Time lavished before treatment initiation is recognized as important modifiable risk factor in HF.

Indexed as

Heart FailureTime-to-TreatmentHospitalizationHumansPrognosisRisk FactorsHeart failurePrognosisTreatment

Identifiers

PMID34655282
PMCPMC8712849
OpenAlexW3206967515

What Socratic holds

Textmetadata
LicenceCC BY-NC-ND
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.