Observational studyEuropean heart journal. Cardiovascular pharmacotherapy2025

Fenofibrate therapy and risk of heart failure outcomes in patients with Type 2 diabetes: a propensity-matched cohort study.

Ji Yoon Kim, Nam Hoon Kim, Jiyoon Lee, Dong-Hoon Kim, Sin Gon Kim

Abstract readObservational Study
In one paragraph

Observational study in European heart journal. Cardiovascular pharmacotherapy, 2025. The graph read 4 numbers from its abstract, feeding 2 cells of the map: it . Cited by 2 papers, 1 of them a synthesis that pooled it.

4numbers the graph read from it
2cells of the map it votes in
2citing papers in PubMed, 1 pooled it
field-weighted citation impact
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.

← favours the treatmentfavours the comparator →
0.51 · no effect
Composite outcome of HHF or cardiovascular deathstatin plus fenofibrate vs statin only, in individuals with ≥80% adherencefavours the treatment · t2d, dyslipidemiafeeds 2 cells of the map
HR 0.680.48 to 0.97
Sensitivity analyses limited to individuals with ≥80% adherence showed consistent results (HHF: adjusted HR, 0.63; 95% CI, 0.43-0.92; composite outcome: adjusted HR, 0.68; 95% CI, 0.48-0.97).
Hospitalization for HF (HHF)statin plus fenofibrate vs statin only, in individuals with ≥80% adherencefavours the treatment · t2d, dyslipidemiafeeds 2 cells of the map
HR 0.630.43 to 0.92
Sensitivity analyses limited to individuals with ≥80% adherence showed consistent results (HHF: adjusted HR, 0.63; 95% CI, 0.43-0.92; composite outcome: adjusted HR, 0.68; 95% CI, 0.48-0.97).

Read, but not usablea number the graph found but could not read as for or against

Composite outcome of HHF or cardiovascular deathstatin plus fenofibrate vs statin onlycomparator not stated · t2d, dyslipidemiafeeds 2 cells of the map
HR 0.790.65 to 0.96
The adjusted HR for the composite outcome of HHF or cardiovascular death was 0.79 (95% CI, 0.65-0.96).
Hospitalization for HF (HHF)statin plus fenofibrate vs statin onlycomparator not stated · t2d, dyslipidemiafeeds 2 cells of the map
HR 0.800.65 to 0.98
During a median of 50.4 months, the incidence rate per 1000 person-years of HHF was 3.44 and 4.13 in the statin plus fenofibrate and statin only groups, respectively (adjusted hazard ratio [HR], 0.80; 95% confidence interval [CI], 0.65-0.98).

clause the extractor read what became the number

2 · Its place on the map

Where it lands on the map

Rows are treatments, columns are outcomes. The coloured squares are the cells this paper feeds, coloured by the vote it casts there. Click one to jump to what this paper adds to it.

supports the treatmentfavours the comparatorno clear differenceread, but no usable result
3 · What it changes

What it adds to each cell

For every cell the paper feeds: the belief in the claim with and without this paper, and this paper's estimate drawn against every other readable study in the cell. The ringed dot is this paper.

Other lipid agents×cardiovascular events

No readable resultOpen on the map →What to test next →

10 readable studies in this cell: 5 favour the treatment, 5 find no difference, 0 favour the comparator.

Belief with this paper
0.80established · 4 families support, 1 contradict · against placebo
Without itNot a counted family in this claim, so removing it changes nothing.
← favours the treatmentfavours the comparator →
1 · no effect
NCT0020287818,144 enrolled · 2005
HR 0.940.89 to 0.99
NCT0061899526 enrolled · 2007
Geometric least-squares mean ratio 0.940.77 to 1.14

This paper's own estimate is on a different scale from the rest of the cell, so it is not drawn here.

Statins×cardiovascular events

No readable resultOpen on the map →What to test next →

30 readable studies in this cell: 18 favour the treatment, 11 find no difference, 1 favour the comparator.

Belief with this paper
0.86replicated · 12 families support, 2 contradict · against placebo
Without itNot a counted family in this claim, so removing it changes nothing.
← favours the treatmentfavours the comparator →
1 · no effect
HR 0.710.56 to 0.90
NCT023442907,769 enrolled · 2015
HR 0.640.48 to 0.84
HR 1.781.00 to 3.17
NCT03944512102 enrolled · 2019
RR 0.670.37 to 1.19

This paper's own estimate is on a different scale from the rest of the cell, so it is not drawn here.

4 · 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.

5 · Its place in the literature

Who cites it

2 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Review
6 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

7 · Who and what money

Authors and funding

5 authors.

Ji Yoon KimDivision of Endocrinology and Metabolism, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Republic of Korea.ORCID 0000-0001-6626-2124
Nam Hoon KimDepartment of Internal Medicine, Korea University College of Medicine, Seoul 02841, Republic of Korea.ORCID 0000-0002-9926-1344
Jiyoon LeeDepartment of Internal Medicine, Korea University College of Medicine, Seoul 02841, Republic of Korea.
Dong-Hoon KimDepartment of Pharmacology, Korea University College of Medicine, Seoul 02841, Republic of Korea.
Sin Gon KimDepartment of Internal Medicine, Korea University College of Medicine, Seoul 02841, Republic of Korea.ORCID 0000-0002-7430-3675

Funding

Abbott LaboratoriesKorea Health Industry Development InstituteMinistry of Health and Welfare RS-2024-00403511
8 · The paper itself

Abstract

The marked sentences are the ones the graph read a number from.

aimsThis study investigated the association between fenofibrate use and outcomes of heart failure (HF) in patients with Type 2 diabetes (T2D). METHODS AND

resultsIn a nationwide cohort database (2008-22) in South Korea, patients with T2D (≥30 years) receiving statin therapy were 1:1 matched by propensity score into a statin plus fenofibrate group (n = 11 722) and statin only group (n = 11 722). The primary outcomes were hospitalization for HF (HHF) and a composite of HHF or cardiovascular death. A Cox proportional hazards model was used to assess the association between treatments and outcomes. During a median of 50.4 months, the incidence rate per 1000 person-years of HHF was 3.44 and 4.13 in the statin plus fenofibrate and statin only groups, respectively (adjusted hazard ratio [HR], 0.80; 95% confidence interval [CI], 0.65-0.98). The adjusted HR for the composite outcome of HHF or cardiovascular death was 0.79 (95% CI, 0.65-0.96). Sensitivity analyses limited to individuals with ≥80% adherence showed consistent results (HHF: adjusted HR, 0.63; 95% CI, 0.43-0.92; composite outcome: adjusted HR, 0.68; 95% CI, 0.48-0.97).

conclusionIn this propensity-matched cohort study, the addition of fenofibrate to statins was associated with significantly lower risks of HHF and the composite outcome of HHF or cardiovascular death in patients with T2D, suggesting a novel cardiovascular benefit of fenofibrate.

Indexed as

Diabetes Mellitus, Type 2DyslipidemiasFenofibrateHeart FailureHypolipidemic AgentsAgedDatabases, FactualDrug Therapy, CombinationFemaleHospitalizationHumansHydroxymethylglutaryl-CoA Reductase InhibitorsIncidenceMaleMiddle AgedPropensity ScoreFenofibrateHydroxymethylglutaryl-CoA Reductase InhibitorsHypolipidemic AgentsCardiovascular outcomeFenofibrateHeart failureStatinType 2 diabetes

Identifiers

PMID40685251
PMCPMC12582659

What Socratic holds

Texttitle and abstract
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.