Evidence map›Paper›PMID 40967652›Full record

ArticleBMJ open2025

Impact of diabetes mellitus and body mass index on long-term survival in chronic total occlusion patients: a nationwide cohort study from the SCAAR registry.

Mohammed Mohammed, Joakim Sundström, Antros Louca, Gustaf Hellsen, Aidin Rawshani, Göran K Olivecrona, Moman Aladdin Mohammad, Dan Ioanes, Ulf Jensen, David Erlinge and 8 more

Abstract read
In one paragraph

Article in BMJ open, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–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.

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

0 citing papers in PubMed.

No citing paper in PubMed yet.

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

18 authors.

Mohammed Mohammed *Department of Molecular and Clinical Medicine, University of Gothenburg Sahlgrenska Academy, Gothenburg, Sweden mohammed.mohammed@vgregion.se.ORCID http://orcid.org/0009-0003-4097-0562
Joakim Sundström *Department of Molecular and Clinical Medicine, University of Gothenburg Sahlgrenska Academy, Gothenburg, Sweden.
Antros LoucaDepartment of Molecular and Clinical Medicine, University of Gothenburg Sahlgrenska Academy, Gothenburg, Sweden.
Gustaf HellsenDepartment of Molecular and Clinical Medicine, University of Gothenburg Sahlgrenska Academy, Gothenburg, Sweden.
Aidin RawshaniDepartment of Molecular and Clinical Medicine, University of Gothenburg Sahlgrenska Academy, Gothenburg, Sweden.
Göran K OlivecronaDepartment of Cardiology, Department of Clinical Sciences, Lund University, Lund, Sweden.
Moman Aladdin MohammadDepartment of Cardiology, Department of Clinical Sciences, Lund University, Lund, Sweden.ORCID http://orcid.org/0000-0003-4242-9801
Dan IoanesDepartment of Molecular and Clinical Medicine, University of Gothenburg Sahlgrenska Academy, Gothenburg, Sweden.
Ulf JensenDepartment of Clinical Science and Education, Karolinska Institute, Stockholm, Sweden.
David ErlingeDepartment of Cardiology, Department of Clinical Sciences, Lund University, Lund, Sweden.
Oskar AngeråsDepartment of Molecular and Clinical Medicine, University of Gothenburg Sahlgrenska Academy, Gothenburg, Sweden.
Petur PeturssonDepartment of Molecular and Clinical Medicine, University of Gothenburg Sahlgrenska Academy, Gothenburg, Sweden.
Anna MyredalDepartment of Molecular and Clinical Medicine, University of Gothenburg Sahlgrenska Academy, Gothenburg, Sweden.
Sebastian VölzDepartment of Molecular and Clinical Medicine, University of Gothenburg Sahlgrenska Academy, Gothenburg, Sweden.
Christian DworeckDepartment of Molecular and Clinical Medicine, University of Gothenburg Sahlgrenska Academy, Gothenburg, Sweden.
Jacob OdenstedtDepartment of Molecular and Clinical Medicine, University of Gothenburg Sahlgrenska Academy, Gothenburg, Sweden.
Araz RawshaniDepartment of Molecular and Clinical Medicine, University of Gothenburg Sahlgrenska Academy, Gothenburg, Sweden.ORCID http://orcid.org/0000-0003-2066-3533
Truls RåmunddalDepartment of Molecular and Clinical Medicine, University of Gothenburg Sahlgrenska Academy, Gothenburg, Sweden.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesTo evaluate the effects of diabetes mellitus (DM) and body mass index (BMI) on long-term all-cause mortality in chronic total occlusion (CTO) patients.

designRetrospective, nationwide cohort study.

settingSwedish Coronary Angiography and Angioplasty Registry, between June 2015 and December 2021.

participants24 284 patients with angiographically confirmed CTO. Prior coronary artery bypass graft surgery excluded. Subgroups were defined by DM status and BMI categories (underweight, healthy weight, overweight, obesity). PRIMARY OUTCOME MEASURES: Long-term all-cause mortality, assessed by Kaplan-Meier analysis and multivariable Cox proportional hazards regression.

resultsDM was present in 30.3% of patients and conferred a 31% higher risk of mortality (HR: 1.31, 95% CI: 1.20 to 1.42; p<0.001). Insulin use among patients with diabetes added a 52% increase in hazard (HR: 1.52; 95% CI: 1.38 to 1.67; p<0.001). BMI demonstrated a non-linear association with mortality: overweight (HR: 0.70, 95% CI: 0.64 to 0.77; p<0.001) and obese (HR: 0.74, 95% CI: 0.68 to 0.81; p<0.001) groups had lower risk compared with the healthy-weight group, whereas underweight individuals faced the highest risk (HR: 1.61, 95% CI: 1.25 to 2.08; p<0.001). A continuous BMI spline revealed an asymmetric U-shaped association: a steep increase in mortality below 23 kg/m

conclusionsIn this nationwide CTO cohort, DM independently predicted higher long-term mortality, accompanied by more severe comorbidities and greater CTO complexity, and insulin therapy further elevated hazard. Overweight and obese patients had better survival, while underweight individuals had the poorest prognosis. These findings underscore the importance of individualised risk assessment and management strategies in CTO patients, particularly those with DM or low BMI.

Indexed as

Body Mass IndexCoronary OcclusionDiabetes MellitusObesityAgedChronic DiseaseFemaleHumansKaplan-Meier EstimateMaleMiddle AgedOverweightProportional Hazards ModelsRegistriesRetrospective StudiesRisk FactorsBody Mass IndexCardiovascular DiseaseCoronary heart diseaseDIABETES & ENDOCRINOLOGYGeneral diabetesIschaemic heart disease

Identifiers

PMID40967652
PMCPMC12458819

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.