{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T03:44:14Z","timestamp":1790912654232,"version":"4.1.0"},"reference-count":40,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2020,1,7]]},"abstract":"<jats:sec xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              Improved heart failure (\n              <jats:styled-content style=\"fixed-case\">HF<\/jats:styled-content>\n              ) risk stratification after a recent acute coronary syndrome may identify those who can benefit from therapies that reduce\n              <jats:styled-content style=\"fixed-case\">HF<\/jats:styled-content>\n              risk. We aimed to identify clinical and biomarker predictors for expanded\n              <jats:styled-content style=\"fixed-case\">HF<\/jats:styled-content>\n              outcomes in patients with type 2 diabetes mellitus after recent acute coronary syndrome.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              The EXAMINE (\n              <jats:styled-content style=\"fixed-case\">Ex<\/jats:styled-content>\n              amination of Cardiovascular Outcomes with Alogliptin versus Standard of Care) trial was a multicenter, non\u2010inferiority, double\u2010masked, placebo\u2010controlled study which randomized 5380 patients with type 2 diabetes mellitus after recent acute coronary syndrome to alogliptin or placebo. Baseline biomarkers were measured in 5154 patients: NT\u2010proBNP (N\u2010terminal pro\u2010B\u2010type natriuretic peptide), high\u2010sensitivity troponin I, adiponectin, growth\u2010differentiation\u2010factor\u201015, and galectin\u20103. Our primary outcome was cardiovascular) death,\n              <jats:styled-content style=\"fixed-case\">HF<\/jats:styled-content>\n              hospitalization, elevated NT\u2010proBNP during follow\u2010up, or loop diuretics initiation. The association between clinical variables, biomarkers, and outcomes were assessed using Cox regression models. In the study population, the median age was 61.0\u00a0years, 67.7% were men, and 28.0% had baseline\n              <jats:styled-content style=\"fixed-case\">HF<\/jats:styled-content>\n              (median follow\u2010up was 18\u00a0months). In multivariable analyses, NT\u2010proBNP had the strongest association with the primary outcome (per log\n              <jats:sub>2<\/jats:sub>\n              , hazard ratio 1.24; Wald \u03c7\n              <jats:sup>2<\/jats:sup>\n              67.4;\n              <jats:italic>P<\/jats:italic>\n              &lt;0.0001) followed by a prior\n              <jats:styled-content style=\"fixed-case\">HF<\/jats:styled-content>\n              history (hazard ratio 1.42; Wald \u03c7\n              <jats:sup>2<\/jats:sup>\n              20.8;\n              <jats:italic>P<\/jats:italic>\n              &lt;0.0001). A model with clinical variables and biomarkers allowed for risk prediction for expanded\n              <jats:styled-content style=\"fixed-case\">HF<\/jats:styled-content>\n              outcomes (C\u2010statistic=0.72). Discrimination results were similar for cardiovascular death or\n              <jats:styled-content style=\"fixed-case\">HF<\/jats:styled-content>\n              hospitalization.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              Among patients with type 2 diabetes mellitus after recent acute coronary syndrome, the use biomarkers such as N\u2010terminal pro\u2010B\u2010type natriuretic peptide and clinical variables enables risk stratification for expanded\n              <jats:styled-content style=\"fixed-case\">HF<\/jats:styled-content>\n              outcomes.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Clinical Trial Registration<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              <jats:styled-content style=\"fixed-case\">URL<\/jats:styled-content>\n              :\n              <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/www.clinicaltrials.gov\/\">https:\/\/www.clinicaltrials.gov\/<\/jats:ext-link>\n              . Unique identifier:\n              <jats:styled-content style=\"fixed-case\">NCT<\/jats:styled-content>\n              00968708.\n            <\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.119.012797","type":"journal-article","created":{"date-parts":[[2020,1,4]],"date-time":"2020-01-04T10:00:22Z","timestamp":1578132022000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":36,"title":["Clinical and Biomarker Predictors of Expanded Heart Failure Outcomes in Patients With Type 2 Diabetes Mellitus After a Recent Acute Coronary Syndrome: Insights From the EXAMINE Trial"],"prefix":"10.1161","volume":"9","author":[{"given":"Abhinav","family":"Sharma","sequence":"first","affiliation":[{"name":"INSERM CIC 1433 NI\u2010CRCT (Cardiovascular and Renal Clinical Trialists) F\u2010CRIN network Universit\u00e9 de Lorraine and CHRU Nancy France"},{"name":"Division of Cardiology Stanford University Palo Alto CA"},{"name":"Division of Cardiology McGill University Montreal QC Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muthiah","family":"Vaduganathan","sequence":"additional","affiliation":[{"name":"Brigham and Women's Hospital Heart and Vascular Center Harvard Medical School Boston MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jo\u00e3o Pedro","family":"Ferreira","sequence":"additional","affiliation":[{"name":"INSERM CIC 1433 NI\u2010CRCT (Cardiovascular and Renal Clinical Trialists) F\u2010CRIN network Universit\u00e9 de Lorraine and CHRU Nancy France"},{"name":"Department of Physiology University of Porto Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuyin","family":"Liu","sequence":"additional","affiliation":[{"name":"Baim Institute for Clinical Research Boston MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"George L.","family":"Bakris","sequence":"additional","affiliation":[{"name":"University of Chicago Medicine Chicago IL"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher P.","family":"Cannon","sequence":"additional","affiliation":[{"name":"Baim Institute for Clinical Research Boston MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William B.","family":"White","sequence":"additional","affiliation":[{"name":"University of Connecticut School of Medicine Farmington CT"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Faiez","family":"Zannad","sequence":"additional","affiliation":[{"name":"INSERM CIC 1433 NI\u2010CRCT (Cardiovascular and Renal Clinical Trialists) F\u2010CRIN network Universit\u00e9 de Lorraine and CHRU Nancy 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