Cited by 465Diabetes Treatment and ManagementDiabetes, Cardiovascular Risks, and LipoproteinsDiabetes Management and Research
The DOI matches its Crossref record; 253 of the 265 references it cites were found in a registry or an index; 10 of the 333 sources its claims cite were checked for support.
10. Cardiovascular Disease and Risk Management: Standards of Care in Diabetes—2023
Open accessElSayed, Nuha A., Aleppo, Grazia, Aroda, Vanita R., Bannuru, Raveendhara R., Brown, Florence M., Bruemmer, Dennis, Collins, Billy S., Das, Sandeep R., Hilliard, Marisa E., Isaacs, Diana, Johnson, Eric L., Kahan, Scott, Khunti, Kamlesh, Kosiborod, Mikhail, Leon, Jose, Lyons, Sarah K., Perry, Mary Lou, Prahalad, Priya, Pratley, Richard E., Seley, Jane Jeffrie, Stanton, Robert C., Gabbay, Robert A.·2023·Diabetes Care
DOI 10.2337/dc23-s010PMC PMC9810475
Abstract
The American Diabetes Association (ADA) “Standards of Care in Diabetes” includes the ADA’s current clinical practice recommendations and is intended to provide the components of diabetes care, general treatment goals and guidelines, and tools to evaluate quality of care. Members of the ADA Professional Practice Committee, a multidisciplinary expert committee, are responsible for updating the Standards of Care annually, or more frequently as warranted. For a detailed description of ADA standards, statements, and reports, as well as the evidence-grading system for ADA’s clinical practice recommendations and a full list of Professional Practice Committee members, please refer to Introduction and Methodology. Readers who wish to comment on the Standards of Care are invited to do so at professional.diabetes.org/SOC.
Overview
Integrity signals
Registry
Crossref · 10.2337/dc23-s010
Cites
253 of 253 references verified0 citation errors · 0 not checkable
Statistics
Nothing to recompute.
Verification
Claims the paper makes
224 Not checked yet · 14 Own interpretation · 8 No basis given · 4 Supported · 2 Partly supported · accuracy not yet measured
Every source the paper cites for this claim was checked and supports it.
In the paper
“The prespeci fi ed secondary outcome of stroke was signi fi cantly reduced by 41% in the intensive treatment group.”
What the sources say
- Supportedcites [35] Cushman, 2010, Effects of intensive blood-pressure control in type 2 diabetes mellitus, N Engl J Med source
Methods (Trial Outcomes) lists fatal or nonfatal stroke as a prespecified secondary outcome. Results (Clinical Outcomes) reports a total-stroke hazard ratio of 0.59 for intensive versus standard treatment—a 41% reduction—with P = 0.01, described as nominally significant. (LLM, conf=0.94)
plaindirect- Asserted: passes — The authors put it forward as true.
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- Supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“Although prior analyses of randomized clinical trials found a bene fi t to evening versus morning dosing of antihypertensive medications (74,75), these results have not been reproduced in subsequent trials.”
What the sources say
- Partly supportedcites [76] Rahman, 2013, A trial of 2 strategies to reduce nocturnal blood pressure in Blacks with chronic kidney disease, Hypertension sourceExperimental — accuracy not yet measured
The Results report no statistically significant overall reduction in nocturnal systolic blood pressure with evening versus morning dosing, so this trial did not reproduce a significant benefit on its primary outcome. It studied African Americans with hypertensive chronic kidney disease; one trial cannot establish that the benefit was not reproduced across subsequent trials generally. An exploratory analysis also found a significant difference in the first treatment period. (LLM, conf=0.84)
plain- Asserted: passes — The authors put it forward as true.
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- Partly supported
Every source the paper cites for this claim was checked and supports it.
In the paper
“These recommendations are based on the observation that high-intensity versus moderate-intensity statin therapy reduces cardiovascular event rates in high-risk individuals with established cardiovascular disease in randomized trials (95,107).”
What the sources say
- Supportedcites [95] Shepherd, 2006, Effect of lowering LDL cholesterol substantially below currently recommended levels in patients with coronary heart disease and diabetes: the Treating to New Targets (TNT) study, Diabetes Care source
The Abstract describes random assignment of patients with coronary heart disease and diabetes to atorvastatin 80 or 10 mg/day. The Efficacy outcomes section reports significantly fewer major cardiovascular events with the higher dose, and the Conclusions place this result within a broader body of evidence for intensive statin therapy. (LLM, conf=0.91)
- Supportedcites [107] Cannon, 2004, Intensive versus moderate lipid lowering with statins after acute coronary syndromes, N Engl J Med source
The trial description identifies a randomized comparison of intensive atorvastatin with moderate-dose pravastatin in patients with acute coronary syndromes. The tolerability and safety section reports a 16 percent reduction in the hazard ratio for death or a major cardiovascular event with intensive treatment. This supports the cited paper as one of the randomized trials underlying the statement; its studied population was specifically patients with recent acute coronary syndromes. (LLM, conf=0.91)
plaindirect- Asserted: passes — The authors put it forward as true.
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- Load-bearing: passes — The paper’s conclusions depend on it.
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- Supported
Every source the paper cites for this claim was checked and supports it.
In the paper
“The largest reduction was for nonfatal MI, with little effect on CHD death (relative risk 0.95 [95% CI 0.78 -1.15]) or total stroke.”
What the sources say
- Supportedcites [139] Baigent, 2009, Aspirin in the primary and secondary prevention of vascular disease: collaborative meta-analysis of individual participant data from randomised trials, Lancet source
The Results state that aspirin had no net effect on the aggregate of all strokes in the primary-prevention trials. The cited CHD-death estimate in the same sentence also comes from those trials, so the claim is supported in that context; the paper separately reports a significant reduction in total stroke in secondary prevention. (LLM, conf=0.94)
plain- Asserted: passes — The authors put it forward as true.
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- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“However, the best evidence to support lower LDL cholesterol targets in people with diabetes and established cardiovascular disease derives from multiple large randomized trials investigating the benefi ts of adding nonstatin agents to statin therapy.”
What the sources say
- Partly supportedcites [105] Cannon, 2015, Ezetimibe added to statin therapy after acute coronary syndromes, N Engl J Med sourceExperimental — accuracy not yet measured
The Conclusions report that adding ezetimibe to a statin lowered LDL cholesterol and improved cardiovascular outcomes; the Efficacy End Points section says the benefit appeared particularly pronounced in patients with diabetes. But this paper reports one nonstatin add-on trial in patients after acute coronary syndrome, not multiple trials supporting lower targets in people with diabetes and established cardiovascular disease. The Discussion notes that several earlier nonstatin add-on trials failed to show significant benefit. Page numbers are unavailable in our copy. (LLM, conf=0.88)
- Not checked yetcites [109] Giugliano, 2018, Benefit of adding ezetimibe to statin therapy on cardiovascular outcomes and safety in patients with versus without diabetes mellitus: results from IMPROVE-IT (Improved Reduction of Outcomes: Vytorin Efficacy International Trial), Circulation source
- Partly supportedcites [108] Sabatine, 2017, Evolocumab and clinical outcomes in patients with cardiovascular disease, N Engl J Med sourceExperimental — accuracy not yet measured
The Conclusions report that adding evolocumab to statin therapy lowered LDL cholesterol below current targets and reduced cardiovascular events in patients with established atherosclerotic cardiovascular disease. The Discussion also describes a similar benefit in the IMPROVE-IT trial. Our copy does not establish that these benefits apply specifically to patients with diabetes, or assess whether these trials constitute the “best evidence” for that group. (LLM, conf=0.83)
- Partly supportedcites [110] Schwartz, 2018, Alirocumab and cardiovascular outcomes after acute coronary syndrome, N Engl J Med sourceExperimental — accuracy not yet measured
The Methods and Results describe a large randomized trial in which adding alirocumab to statin therapy lowered cardiovascular-event risk after acute coronary syndrome. The Discussion also cites other nonstatin trials with cardiovascular benefits. But this paper does not establish that these trials are the best evidence for lower LDL-cholesterol targets specifically in people with both diabetes and established cardiovascular disease. (LLM, conf=0.84)
- Supportedcites [111] Ray, 2019, Effects of alirocumab on cardiovascular and metabolic outcomes after acute coronary syndrome in patients with or without diabetes: a prespecified analysis of the ODYSSEY OUTCOMES randomised controlled trial, Lancet Diabetes Endocrinol source
The Research in context section reports cardiovascular-outcomes evidence from statins plus ezetimibe, ODYSSEY OUTCOMES, and the large FOURIER trial. The Implications section states that, in patients with cardiovascular disease and diabetes, adding a PCSK9 inhibitor to statin therapy provides greater absolute benefit and supports considering lower LDL cholesterol goals. No page numbers are available in our copy. (LLM, conf=0.88)
- Not checked yetcites [112] Sabatine, 2017, Cardiovascular safety and efficacy of the PCSK9 inhibitor evolocumab in patients with and without diabetes and the effect of evolocumab on glycaemia and risk of new-onset diabetes: a prespecified analysis of the FOURIER randomised controlled trial, Lancet Diabetes Endocrinol source
plaindirect- Asserted: passes — The authors put it forward as true.
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- Partly supported
Every source the paper cites for this claim was checked and supports it.
In the paper
“Over a median follow-up of 16 months, those in the empagli fl ozin-treated group had a reduced risk of the primary outcome (HR 0.75 [95% CI 0.65 -0.86]; P < 0.001) and fewer total hospitalizations for heart failure (HR 0.70 [95% CI 0.58 -0.85]; P < 0.001).”
What the sources say
- Supportedcites [200] Packer, 2020, Cardiovascular and renal outcomes with empagliflozin in heart failure, N Engl J Med source
The Secondary Outcomes section reports fewer total heart-failure hospitalizations with empagliflozin than with placebo (388 versus 553), with a hazard ratio of 0.70 (95% CI, 0.58–0.85; P<0.001). The Abstract also confirms the 16-month median follow-up and the cited primary-outcome hazard ratio of 0.75. (LLM, conf=0.95)
plaindirect- Asserted: passes — The authors put it forward as true.
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- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
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- Supported
None of the sources cited for this claim have been checked yet.
In the paper
“Rates of heart failure hospitalization have been improved in recent trials including people with type 2 diabetes, most of whom also had ASCVD, with sodium -glucose cotransporter 2 (SGLT2) inhibitors (8 -11).”
What the sources say
- Not checked yetcites [8] Zinman, 2015, Empagliflozin, cardiovascular outcomes, and mortality in type 2 diabetes, N Engl J Med source
- Not checked yetcites [9] Neal, 2017, Canagliflozin and cardiovascular and renal events in type 2 diabetes, N Engl J Med source
- Not checked yetcites [10] Fitchett, 2018, Effects of empagliflozin on risk for cardiovascular death and heart failure hospitalization across the spectrum of heart failure risk in the EMPA-REG OUTCOME trial, Eur Heart J source
- Not checked yetcites [11] McMurray, 2019, Dapagliflozin in patients with heart failure and reduced ejection fraction, N Engl J Med source
plaindirect- Asserted: passes — The authors put it forward as true.
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The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Furthermore, large bene fi ts are seen when multiple cardiovascular risk factors are addressed simultaneously.”
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Rests on an assumption: Common conditions coexisting with type 2 diabetes, such as hypertension and dyslipidemia, are risk factors for ASCVD, and diabetes itself confers independent risk.
None of the sources cited for this claim have been checked yet.
In the paper
“Numerous studies have shown the ef fi cacy of controlling individual cardiovascular risk factors in preventing or slowing ASCVD in people with diabetes.”
boosteddirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Rests on an assumption: Common conditions coexisting with type 2 diabetes, such as hypertension and dyslipidemia, are risk factors for ASCVD, and diabetes itself confers independent risk.
None of the sources cited for this claim have been checked yet.
In the paper
“ASCVD morbidity and mortality have decreased (3,4).”
What the sources say
- Not checked yetcites [3] Buse, 2007, Primary prevention of cardiovascular diseases in people with diabetes mellitus: a scientific statement from the American Heart Association and the American Diabetes Association, Diabetes Care source
- Not checked yetcites [4] Gaede, 2008, Effect of a multifactorial intervention on mortality in type 2 diabetes, N Engl J Med source
plain- Asserted: passes — The authors put it forward as true.
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- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
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In the paper
“there is evidence that measures of 10-year CHD risk among U.S. adults with diabetes have improved signi fi cantly over the past decade (2)”
What the sources say
- Not checked yetcites [2] Ali, 2013, Achievement of goals in U.S. diabetes care, 1999-2010, N Engl J Med source
hedged- Asserted: passes — The authors put it forward as true.
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- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
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None of the sources cited for this claim have been checked yet.
In the paper
“Studies of individuals without diabetes found that home measurements may better correlate with ASCVD risk than of fi ce measurements (23,24).”
What the sources say
- Not checked yetcites [23] Bobrie, 2001, Is “isolated home” hypertension as opposed to “isolated office” hypertension a sign of greater cardiovascular risk?, Arch Intern Med source
- Not checked yetcites [24] Sega, 2005, Prognostic value of ambulatory and home blood pressures compared with office blood pressure in the general population: follow-up results from the Pressioni Arteriose Monitorate e Loro Associazioni (PAMELA) study, Circulation source
hedgedcorrelational- Asserted: passes — The authors put it forward as true.
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- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Therapy that includes multiple, concurrent evidence-based approaches to care will provide complementary reduction in the risks of microvascular, kidney, neurologic, and cardiovascular complications.”
hedgeddirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Rests on an assumption: Common conditions coexisting with type 2 diabetes, such as hypertension and dyslipidemia, are risk factors for ASCVD, and diabetes itself confers independent risk.
None of the sources cited for this claim have been checked yet.
In the paper
“Home blood pressure self-monitoring and 24-h ambulatory blood pressure monitoring may provide evidence of white coat hypertension, masked hypertension, or other discrepancies between of fi ce and ' true ' blood pressure (23,24).”
What the sources say
- Not checked yetcites [23] Bobrie, 2001, Is “isolated home” hypertension as opposed to “isolated office” hypertension a sign of greater cardiovascular risk?, Arch Intern Med source
- Not checked yetcites [24] Sega, 2005, Prognostic value of ambulatory and home blood pressures compared with office blood pressure in the general population: follow-up results from the Pressioni Arteriose Monitorate e Loro Associazioni (PAMELA) study, Circulation source
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
None of the sources cited for this claim have been checked yet.
In the paper
“Recent studies have found that rates of incident heart failure hospitalization (adjusted for age and sex) were twofold higher in people with diabetes compared with those without (5,6).”
What the sources say
- Not checked yetcites [5] Cavender, 2015, Impact of diabetes mellitus on hospitalization for heart failure, cardiovascular events, and death: outcomes at 4 years from the Reduction of Atherothrombosis for Continued Health (REACH) Registry, Circulation source
- Not checked yetcites [6] McAllister, 2018, Incidence of hospitalization for heart failure and case-fatality among 3.25 million people with and without diabetes mellitus, Circulation source
plaincorrelational- Asserted: passes — The authors put it forward as true.
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- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
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In the paper
“Adverse outcomes, including hypotension, syncope, electrolyte abnormality, and acute kidney injury were more common in the intensive treatment arm; risk of adverse outcomes needs to be weighed against the cardiovascular bene fi t of more intensive blood pressure lowering.”
What the sources say
- Not checked yetcites [33] Wright, 2015, A randomized trial of intensive versus standard blood-pressure control, N Engl J Med source
plaindirect- Asserted: passes — The authors put it forward as true.
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In the paper
“ACCORD BP provides the strongest direct assessment of the bene fi ts and risks of intensive blood pressure control in people with type 2 diabetes (35).”
What the sources say
- Not checked yetcites [35] Cushman, 2010, Effects of intensive blood-pressure control in type 2 diabetes mellitus, N Engl J Med source
boosted- Asserted: passes — The authors put it forward as true.
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In the paper
“However, in people with diabetes, there was a signi fi cant 51% reduction in the treatment group with a target diastolic blood pressure of < 80 mmHg compared with a target diastolic blood pressure of < 90 mmHg.”
What the sources say
- Not checked yetcites [37] Hansson, 1998, Effects of intensive blood-pressure lowering and low-dose aspirin in patients with hypertension: principal results of the Hypertension Optimal Treatment (HOT) randomised trial, Lancet source
plaindirect- Asserted: passes — The authors put it forward as true.
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The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“The committee recognizes that there has been no randomized controlled trial to speci fi cally demonstrate a decreased incidence of cardiovascular events in people with diabetes by targeting a blood pressure < 130/80 mmHg.”
plain- Asserted: passes — The authors put it forward as true.
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In the paper
“The achieved systolic blood pressures in the trial were 121 mmHg and 136 mmHg in the intensive versus standard treatment group, respectively.”
What the sources say
- Not checked yetcites [33] Wright, 2015, A randomized trial of intensive versus standard blood-pressure control, N Engl J Med source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“As discussed below, treatment should be individualized and treatment should not be targeted to < 120/80 mmHg, as a mean achieved blood pressure of < 120/80 mmHg is associated with adverse events.”
plaincorrelational- Asserted: passes — The authors put it forward as true.
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In the paper
“Adverse events attributed to blood pressure treatment, including hypotension, syncope, bradycardia, hyperkalemia, and elevations in serum creatinine occurred more frequently in the intensive treatment arm than in the standard therapy arm ( Table 10.1 ).”
What the sources say
- Not checked yetcites [35] Cushman, 2010, Effects of intensive blood-pressure control in type 2 diabetes mellitus, N Engl J Med source
plaindirect- Asserted: passes — The authors put it forward as true.
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- Load-bearing: passes — The paper’s conclusions depend on it.
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In the paper
“The primary composite outcome of myocardial infarction (MI), coronary syndromes, stroke, heart failure, or death from cardiovascular causes was reduced by 25% in the intensive treatment group.”
What the sources say
- Not checked yetcites [33] Wright, 2015, A randomized trial of intensive versus standard blood-pressure control, N Engl J Med source
plaindirectn = 9,361- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Notably, there is an absence of high-quality data available to guide blood pressure targets in people with type 1 diabetes, but a similar blood pressure target of < 130/80 mmHg is recommended in people with type 1 diabetes.”
plain- Asserted: passes — The authors put it forward as true.
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- Rests on an assumption: No randomized trials have been specifically designed to assess the impact of cardiovascular risk reduction strategies in people with type 1 diabetes.
None of the sources cited for this claim have been checked yet.
In the paper
“Absolute bene fi t from blood pressure reduction correlated with absolute baseline cardiovascular risk in SPRINT and in earlier clinical trials conducted at higher baseline blood pressure levels (13,41).”
What the sources say
- Not checked yetcites [13] Blood Pressure Lowering Treatment Trialists’ Collaboration, 2014, Blood pressure-lowering treatment based on cardiovascular risk: a meta-analysis of individual patient data, Lancet source
- Not checked yetcites [41] Phillips, 2018, Impact of cardiovascular risk on the relative benefit and harm of intensive treatment of hypertension, J Am Coll Cardiol source
plaincorrelational- Asserted: passes — The authors put it forward as true.
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In the paper
“The primary end point, a composite of cardiovascular death, nonfatal stroke infarction, or worsening renal or diabetic eye disease, was reduced by 9% in the combination treatment.”
What the sources say
- Not checked yetcites [36] Patel, 2007, Effects of a fixed combination of perindopril and indapamide on macrovascular and microvascular outcomes in patients with type 2 diabetes mellitus (the ADVANCE trial): a randomised controlled trial, Lancet source
plaindirectn = 11,140- Asserted: passes — The authors put it forward as true.
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In the paper
“The primary composite outcome of nonfatal MI, nonfatal stroke, or death from cardiovascular causes was not signi fi cantly reduced in the intensive treatment group.”
What the sources say
- Not checked yetcites [35] Cushman, 2010, Effects of intensive blood-pressure control in type 2 diabetes mellitus, N Engl J Med source
plain- Asserted: passes — The authors put it forward as true.
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In the paper
“The achieved systolic blood pressure was 135 mmHg in the treatment group and 140 mmHg in the placebo group.”
What the sources say
- Not checked yetcites [36] Patel, 2007, Effects of a fixed combination of perindopril and indapamide on macrovascular and microvascular outcomes in patients with type 2 diabetes mellitus (the ADVANCE trial): a randomised controlled trial, Lancet source
plainn = 11,140- Asserted: passes — The authors put it forward as true.
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- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
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None of the sources cited for this claim have been checked yet.
In the paper
“Based on these analyses, antihypertensive treatment appears to be most benefi cial when mean baseline blood pressure is $ 140/90 mmHg (19,26,27,29 -31).”
What the sources say
- Not checked yetcites [19] Whelton, 2018, 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA guideline for the prevention, detection, evaluation, and management of high blood pressure in adults: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines, J Am Coll Cardiol source
- Not checked yetcites [26] Emdin, 2015, Blood pressure lowering in type 2 diabetes: a systematic review and meta-analysis, JAMA source
- Not checked yetcites [27] Arguedas, 2013, Blood pressure targets for hypertension in people with diabetes mellitus, Cochrane Database Syst Rev
- Not checked yetcites [29] Brunström, 2016, Effect of antihypertensive treatment at different blood pressure levels in patients with diabetes mellitus: systematic review and meta-analyses, BMJ source
- Not checked yetcites [30] Bangalore, 2011, Blood pressure targets in subjects with type 2 diabetes mellitus/impaired fasting glucose: observations from traditional and bayesian random-effects meta-analyses of randomized trials, Circulation source
- Not checked yetcites [31] Thomopoulos, 2017, Effects of blood-pressure-lowering treatment on outcome incidence in hypertension: 10 - Should blood pressure management differ in hypertensive patients with and without diabetes mellitus? Overview and meta-analyses of randomized trials, J Hypertens source
hedgedconditional- Asserted: passes — The authors put it forward as true.
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In the paper
“In this trial, the primary composite outcome of stroke, acute coronary syndrome, acute decompensated heart failure, coronary revascularization, atrial fi brillation, or death from cardiovascular causes was reduced by 26% in the intensive treatment group.”
What the sources say
- Not checked yetcites [34] Zhang, 2021, Trial of intensive blood-pressure control in older patients with hypertension, N Engl J Med source
plaindirectn = 8,511- Asserted: passes — The authors put it forward as true.
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- Load-bearing: passes — The paper’s conclusions depend on it.
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None of the sources cited for this claim have been checked yet.
In the paper
“Secondary analyses of ACCORD BP and SPRINT suggest that clinical factors can help determine individuals more likely to bene fi t and less likely to be harmed by intensive blood pressure control (40,41).”
What the sources say
- Not checked yetcites [40] Basu, 2017, Benefit and harm of intensive blood pressure treatment: derivation and validation of risk models using data from the SPRINT and ACCORD trials, PLoS Med source
- Not checked yetcites [41] Phillips, 2018, Impact of cardiovascular risk on the relative benefit and harm of intensive treatment of hypertension, J Am Coll Cardiol source
hedgedcorrelational- Asserted: passes — The authors put it forward as true.
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In the paper
“This bene fi t was greatest in people with diabetes.”
What the sources say
- Not checked yetcites [32] Xie, 2016, Effects of intensive blood pressure lowering on cardiovascular and renal outcomes: updated systematic review and meta-analysis, Lancet source
plaindirectn = 44,989- Asserted: passes — The authors put it forward as true.
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- Load-bearing: passes — The paper’s conclusions depend on it.
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In the paper
“The Action in Diabetes and Vascular Disease: Preterax and Diamicron MR Controlled Evaluation (ADVANCE) trial revealed that treatment with perindopril/indapamide to an achieved systolic blood pressure of 135 mmHg signi fi cantly decreased cardiovascular event rates compared with a placebo treatment with an achieved blood pressure of 140 mmHg (36).”
What the sources say
- Not checked yetcites [36] Patel, 2007, Effects of a fixed combination of perindopril and indapamide on macrovascular and microvascular outcomes in patients with type 2 diabetes mellitus (the ADVANCE trial): a randomised controlled trial, Lancet source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
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In the paper
“Another meta-analysis of 19 trials including 44,989 patients showed that a mean blood pressure of 133/76 mmHg is associated with a 14% risk reduction for major cardiovascular events compared with a mean blood pressure of 140/81 mmHg (32).”
What the sources say
- Not checked yetcites [32] Xie, 2016, Effects of intensive blood pressure lowering on cardiovascular and renal outcomes: updated systematic review and meta-analysis, Lancet source
plaincorrelationaln = 44,989- Asserted: passes — The authors put it forward as true.
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In the paper
“Individuals with older age, CKD, and frailty have been shown to be at higher risk of adverse effects of intensive blood pressure control (43).”
What the sources say
- Not checked yetcites [43] Sink, 2018, Syncope, hypotension, and falls in the treatment of hypertension: results from the randomized clinical systolic blood pressure intervention trial, J Am Geriatr Soc source
plaincorrelational- Asserted: passes — The authors put it forward as true.
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In the paper
“Single-pill antihypertensive combinations may improve medication taking in some patients (59).”
What the sources say
- Not checked yetcites [59] Bangalore, 2007, Fixed-dose combinations improve medication compliance: a meta-analysis, Am J Med source
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
None of the sources cited for this claim have been checked yet.
In the paper
“Subgroup analyses of people with diabetes in larger trials (92 -96) and trials in people with diabetes (97,98) showed signi fi cant primary and secondary prevention of ASCVD events and CHD death in people with diabetes.”
What the sources say
- Not checked yetcites [92] Pyŏrälä, 1997, Cholesterol lowering with simvastatin improves prognosis of diabetic patients with coronary heart disease. A subgroup analysis of the Scandinavian Simvastatin Survival Study (4S), Diabetes Care source
- Not checked yetcites [93] Collins, 2003, MRC/BHF Heart Protection Study of cholesterol-lowering with simvastatin in 5963 people with diabetes: a randomised placebo-controlled trial, Lancet source
- Not checked yetcites [94] Goldberg, 1998, Cardiovascular events and their reduction with pravastatin in diabetic and glucose-intolerant myocardial infarction survivors with average cholesterol levels: subgroup analyses in the Cholesterol and Recurrent Events (CARE) trial, Circulation source
- Not checked yetcites [95] Shepherd, 2006, Effect of lowering LDL cholesterol substantially below currently recommended levels in patients with coronary heart disease and diabetes: the Treating to New Targets (TNT) study, Diabetes Care source
- Not checked yetcites [96] Sever, 2005, Reduction in cardiovascular events with atorvastatin in 2,532 patients with type 2 diabetes: Anglo-Scandinavian Cardiac Outcomes Trial--lipid-lowering arm (ASCOT-LLA), Diabetes Care source
- Not checked yetcites [97] Knopp, 2006, Efficacy and safety of atorvastatin in the prevention of cardiovascular end points in subjects with type 2 diabetes: the Atorvastatin Study for Prevention of Coronary Heart Disease Endpoints in non-insulin-dependent diabetes mellitus (ASPEN), Diabetes Care source
- Not checked yetcites [98] Colhoun, 2004, Primary prevention of cardiovascular disease with atorvastatin in type 2 diabetes in the Collaborative Atorvastatin Diabetes Study (CARDS): multicentre randomised placebo-controlled trial, Lancet source
plaindirect- Asserted: passes — The authors put it forward as true.
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None of the sources cited for this claim have been checked yet.
In the paper
“In addition, mineralocorticoid receptor antagonists reduce albuminuria in people with diabetic nephropathy (82 -84).”
What the sources say
- Not checked yetcites [82] Sato, 2003, Effectiveness of aldosterone blockade in patients with diabetic nephropathy, Hypertension source
- Not checked yetcites [83] Mehdi, 2009, Addition of angiotensin receptor blockade or mineralocorticoid antagonism to maximal angiotensin-converting enzyme inhibition in diabetic nephropathy, J Am Soc Nephrol source
- Not checked yetcites [84] Bakris, 2015, Effect of finerenone on albuminuria in patients with diabetic nephropathy: a randomized clinical trial, JAMA source
plaindirect- Asserted: passes — The authors put it forward as true.
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In the paper
“For patients with albuminuria (urine albumin-to-creatinine ratio [UACR] $ 30 mg/g), initial treatment should include an ACE inhibitor or ARB to reduce the risk of progressive kidney disease (20) ( Fig. 10.2 ).”
What the sources say
- Not checked yetcites [20] de Boer, 2017, Diabetes and hypertension: a position statement by the American Diabetes Association, Diabetes Care source
plaindirect- Asserted: passes — The authors put it forward as true.
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None of the sources cited for this claim have been checked yet.
In the paper
“Use of internet or mobilebased digital platforms to reinforce healthy behaviors may be considered as a component of care, as these interventions have been found to enhance the ef fi cacy of medical therapy for hypertension (54,55).”
What the sources say
- Not checked yetcites [54] Mao, 2020, Impact and efficacy of mobile health intervention in the management of diabetes and hypertension: a systematic review and meta-analysis, BMJ Open Diabetes Res Care source
- Not checked yetcites [55] Stogios, 2020, Advancing digital health interventions as a clinically applied science for blood pressure reduction: a systematic review and meta-analysis, Can J Cardiol source
hedgeddirect- Asserted: passes — The authors put it forward as true.
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In the paper
“In individual patients, the highly variable LDL cholesterol -lowering response seen with statins is poorly understood (88).”
What the sources say
- Not checked yetcites [88] Chasman, 2004, Pharmacogenetic study of statin therapy and cholesterol reduction, JAMA source
plain- Asserted: passes — The authors put it forward as true.
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- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
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None of the sources cited for this claim have been checked yet.
In the paper
“Therefore, serum creatinine and potassium should be monitored during treatment with an ACE inhibitor, ARB, or diuretic, particularly among patients with reduced glomerular fi ltration who are at increased risk of hyperkalemia and AKI (77,78,80).”
What the sources say
- Not checked yetcites [77] Nilsson, 2017, Incidence and determinants of hyperkalemia and hypokalemia in a large healthcare system, Int J Cardiol source
- Not checked yetcites [78] Bandak, 2017, Hyperkalemia after initiating renin-angiotensin system blockade: the Stockholm Creatinine Measurements (SCREAM) project, J Am Heart Assoc source
- Not checked yetcites [80] James, 2015, A meta-analysis of the association of estimated GFR, albuminuria, diabetes mellitus, and hypertension with acute kidney injury, Am J Kidney Dis source
plaincorrelational- Asserted: passes — The authors put it forward as true.
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In the paper
“There is evidence for bene fi t from even extremely low, less than daily statin doses (89).”
What the sources say
- Not checked yetcites [89] Meek, 2012, Daily and intermittent rosuvastatin 5 mg therapy in statin intolerant patients: an observational study, Curr Med Res Opin source
plaindirect- Asserted: passes — The authors put it forward as true.
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- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
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In the paper
“The primary outcome, a composite of preeclampsia with severe features, medically indicated preterm birth at < 35 weeks of gestation, placental abruption, or fetal/neonatal death, occurred in 30.2% of female participants in the active treatment group vs. 37.0% in the control group ( P < 0.001).”
What the sources say
- Not checked yetcites [48] Tita, 2022, Treatment for mild chronic hypertension during pregnancy, N Engl J Med source
plain- Asserted: passes — The authors put it forward as true.
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In the paper
“Long-term follow-up is recommended for these individuals as they have increased lifetime cardiovascular risk (51).”
What the sources say
- Not checked yetcites [51] Irgens, 2001, Long term mortality of mothers and fathers after pre-eclampsia: population based cohort study, BMJ source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
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The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“There are few randomized controlled trials of antihypertensive therapy in pregnant individuals with diabetes.”
plain- Asserted: passes — The authors put it forward as true.
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- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
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In the paper
“In patients receiving ACE inhibitor or ARB therapy, continuation of those medications as kidney function declines to estimated glomerular fi ltration rate (eGFR) < 30 mL/min/1.73 m 2 may provide cardiovascular bene fi t without signi fi cantly increasing the risk of end-stage kidney disease (67).”
What the sources say
- Not checked yetcites [67] Qiao, 2020, Association between renin-angiotensin system blockade discontinuation and all-cause mortality among persons with low estimated glomerular filtration rate, JAMA Intern Med source
hedgedconditional- Asserted: passes — The authors put it forward as true.
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In the paper
“Mineralocorticoid receptor antagonists, including spironolactone and eplerenone, are effective for management of resistant hypertension in people with type 2 diabetes when added to existing treatment with an ACE inhibitor or ARB, thiazide-like diuretic, or dihydropyridine calcium channel blocker (81).”
What the sources say
- Not checked yetcites [81] Williams, 2015, Spironolactone versus placebo, bisoprolol, and doxazosin to determine the optimal treatment for drug-resistant hypertension (PATHWAY-2): a randomised, double-blind, crossover trial, Lancet source
plaindirect- Asserted: passes — The authors put it forward as true.
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In the paper
“Lifestyle intervention, including weight loss in people with overweight or obesity (when appropriate) (85), increased physical activity, and medical nutrition therapy, allows some patients to reduce ASCVD risk factors.”
What the sources say
- Not checked yetcites [85] Jensen, 2014, 2013 AHA/ACC/TOS guideline for the management of overweight and obesity in adults: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and The Obesity Society, J Am Coll Cardiol source
plainconditional- Asserted: passes — The authors put it forward as true.
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None of the sources cited for this claim have been checked yet.
In the paper
“Although prior analyses of randomized clinical trials found a bene fi t to evening versus morning dosing of antihypertensive medications (74,75), these results have not been reproduced in subsequent trials.”
What the sources say
- Not checked yetcites [74] Zhao, 2011, Evening versus morning dosing regimen drug therapy for hypertension, Cochrane Database Syst Rev
- Not checked yetcites [75] Hermida, 2011, Influence of time of day of blood pressure-lowering treatment on cardiovascular risk in hypertensive patients with type 2 diabetes, Diabetes Care source
plaindirect- Asserted: passes — The authors put it forward as true.
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In the paper
“In the absence of albuminuria, risk of progressive kidney disease is low, and ACE inhibitors and ARBs have not been found to afford superior cardioprotection when compared with thiazide-like diuretics or dihydropyridine calcium channel blockers (68).”
What the sources say
- Not checked yetcites [68] Bangalore, 2016, Diabetes mellitus as a compelling indication for use of renin angiotensin system blockers: systematic review and meta-analysis of randomized trials, BMJ source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
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- Rests on an assumption: In the absence of albuminuria, the risk of progressive kidney disease is low.
In the paper
“Intensive target reduced risk of death 27%”
What the sources say
- Not checked yetcites [43] Sink, 2018, Syncope, hypotension, and falls in the treatment of hypertension: results from the randomized clinical systolic blood pressure intervention trial, J Am Geriatr Soc source
plaindirectn = 9,361- Asserted: passes — The authors put it forward as true.
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In the paper
“However, in ACCORD BP, it was found that intensive blood pressure lowering decreased the risk of cardiovascular events irrespective of baseline diastolic blood pressure in patients who also received standard glycemic control (44).”
What the sources say
- Not checked yetcites [44] Ilkun, 2020, The influence of baseline diastolic blood pressure on the effects of intensive blood pressure lowering on cardiovascular outcomes and all-cause mortality in type 2 diabetes, Diabetes Care source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
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None of the sources cited for this claim have been checked yet.
In the paper
“Multiple clinical trials have demonstrated the bene fi cial effects of statin therapy on ASCVD outcomes in subjects with and without CHD (90,91).”
What the sources say
- Not checked yetcites [90] Mihaylova, 2012, The effects of lowering LDL cholesterol with statin therapy in people at low risk of vascular disease: meta-analysis of individual data from 27 randomised trials, Lancet source
- Not checked yetcites [91] Baigent, 2005, Efficacy and safety of cholesterol-lowering treatment: prospective meta-analysis of data from 90,056 participants in 14 randomised trials of statins, Lancet source
boosteddirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
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None of the sources cited for this claim have been checked yet.
In the paper
“b -Blockers are indicated in the setting of prior MI, active angina, or HfrEF but have not been shown to reduce mortality as blood pressure-lowering agents in the absence of these conditions (28,69,70).”
What the sources say
- Not checked yetcites [28] Ettehad, 2016, Blood pressure lowering for prevention of cardiovascular disease and death: a systematic review and meta-analysis, Lancet source
- Not checked yetcites [69] Carlberg, 2004, Atenolol in hypertension: is it a wise choice?, Lancet source
- Not checked yetcites [70] Murphy, 2020, Heart failure with reduced ejection fraction: a review, JAMA source
plain- Asserted: passes — The authors put it forward as true.
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In the paper
“The mean systolic blood pressure between randomization and delivery was 129.5 mmHg in the active treatment group and 132.6 mmHg in the control group.”
What the sources say
- Not checked yetcites [48] Tita, 2022, Treatment for mild chronic hypertension during pregnancy, N Engl J Med source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“During pregnancy, treatment with ACE inhibitors, angiotensin receptor blockers (ARBs), and spironolactone are contraindicated as they may cause fetal damage.”
hedgedconditional- Asserted: passes — The authors put it forward as true.
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In the paper
“A 2014 Cochrane systematic review of antihypertensive therapy for mild to moderate chronic hypertension that included 49 trials and over 4,700 women did not fi nd any conclusive evidence for or against blood pressure treatment to reduce the risk of preeclampsia for the mother or effects on perinatal outcomes such as preterm birth, small-for-gestational-age infants, or fetal death (45).”
What the sources say
- Not checked yetcites [45] Abalos, 2014, Antihypertensive drug therapy for mild to moderate hypertension during pregnancy, Cochrane Database Syst Rev
plainn = 4,700- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Therefore, the presence of low diastolic blood pressure is not necessarily a contraindication to more intensive blood pressure management in the context of otherwise standard care.”
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
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None of the sources cited for this claim have been checked yet.
In the paper
“Each trial found a signi fi cant bene fi t in the reduction of ASCVD events that was directly related to the degree of further LDL cholesterol lowering.”
What the sources say
- Not checked yetcites [105] Cannon, 2015, Ezetimibe added to statin therapy after acute coronary syndromes, N Engl J Med source
- Not checked yetcites [109] Giugliano, 2018, Benefit of adding ezetimibe to statin therapy on cardiovascular outcomes and safety in patients with versus without diabetes mellitus: results from IMPROVE-IT (Improved Reduction of Outcomes: Vytorin Efficacy International Trial), Circulation source
- Not checked yetcites [108] Sabatine, 2017, Evolocumab and clinical outcomes in patients with cardiovascular disease, N Engl J Med source
- Not checked yetcites [110] Schwartz, 2018, Alirocumab and cardiovascular outcomes after acute coronary syndrome, N Engl J Med source
- Not checked yetcites [111] Ray, 2019, Effects of alirocumab on cardiovascular and metabolic outcomes after acute coronary syndrome in patients with or without diabetes: a prespecified analysis of the ODYSSEY OUTCOMES randomised controlled trial, Lancet Diabetes Endocrinol source
- Not checked yetcites [112] Sabatine, 2017, Cardiovascular safety and efficacy of the PCSK9 inhibitor evolocumab in patients with and without diabetes and the effect of evolocumab on glycaemia and risk of new-onset diabetes: a prespecified analysis of the FOURIER randomised controlled trial, Lancet Diabetes Endocrinol source
plaindirect- Asserted: passes — The authors put it forward as true.
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None of the sources cited for this claim have been checked yet.
In the paper
“Previous randomized controlled trials of aspirin speci fi cally in people with diabetes failed to consistently show a signi fi cant reduction in overall ASCVD end points, raising questions about the ef fi cacy of aspirin for primary prevention in people with diabetes, although some sex differences were suggested (141 -143).”
What the sources say
- Not checked yetcites [141] Belch, 2008, The prevention of progression of arterial disease and diabetes (POPADAD) trial: factorial randomised placebo controlled trial of aspirin and antioxidants in patients with diabetes and asymptomatic peripheral arterial disease, BMJ source
- Not checked yetcites [142] Zhang, 2010, Aspirin for primary prevention of cardiovascular events in patients with diabetes: A meta-analysis, Diabetes Res Clin Pract source
- Not checked yetcites [143] De Berardis, 2009, Aspirin for primary prevention of cardiovascular events in people with diabetes: meta-analysis of randomised controlled trials, BMJ source
plain- Asserted: passes — The authors put it forward as true.
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In the paper
“Gastrointestinal bleeding events (characterized as mild) occurred in 0.97% of patients in the aspirin group vs. 0.46% in the placebo group (HR 2.11 [95% CI 1.36 -3.28]; P = 0.0007).”
What the sources say
- Not checked yetcites [145] Gaziano, 2018, Use of aspirin to reduce risk of initial vascular events in patients at moderate risk of cardiovascular disease (ARRIVE): a randomised, double-blind, placebo-controlled trial, Lancet source
plaincorrelational- Asserted: passes — The authors put it forward as true.
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In the paper
“The largest reduction was for nonfatal MI, with little effect on CHD death (relative risk 0.95 [95% CI 0.78 -1.15]) or total stroke.”
What the sources say
- Not checked yetcites [139] Baigent, 2009, Aspirin in the primary and secondary prevention of vascular disease: collaborative meta-analysis of individual participant data from randomised trials, Lancet source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“In the Heart Protection Study (lower age limit 40 years), the subgroup of 600 people with type 1 diabetes had a proportionately similar, although not statistically signi fi cant, reduction in risk to that in people with type 2 diabetes (93).”
What the sources say
- Not checked yetcites [93] Collins, 2003, MRC/BHF Heart Protection Study of cholesterol-lowering with simvastatin in 5963 people with diabetes: a randomised placebo-controlled trial, Lancet source
plainn = 600- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“Overall, they found that aspirin reduced the risk of serious vascular events by 12% (relative risk 0.88 [95% CI 0.82 -0.94]).”
What the sources say
- Not checked yetcites [139] Baigent, 2009, Aspirin in the primary and secondary prevention of vascular disease: collaborative meta-analysis of individual participant data from randomised trials, Lancet source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
None of the sources cited for this claim have been checked yet.
In the paper
“Placebo-controlled trials evaluating the addition of the PCSK9 inhibitors evolocumab and alirocumab to maximum tolerated doses of statin therapy in participants who were at high risk for ASCVD demonstrated an average reduction in LDL cholesterol ranging from 36 to 59%.”
What the sources say
- Not checked yetcites [113] Moriarty, 2014, Efficacy and safety of alirocumab, a monoclonal antibody to PCSK9, in statin-intolerant patients: design and rationale of ODYSSEY ALTERNATIVE, a randomized phase 3 trial, J Clin Lipidol source
- Not checked yetcites [114] Zhang, 2015, Safety and efficacy of anti-PCSK9 antibodies: a meta-analysis of 25 randomized, controlled trials, BMC Med source
boosteddirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
None of the sources cited for this claim have been checked yet.
In the paper
“The relative bene fi t of lipid-lowering therapy has been uniform across most subgroups tested (91,99), including subgroups that varied with respect to age and other risk factors.”
What the sources say
- Not checked yetcites [91] Baigent, 2005, Efficacy and safety of cholesterol-lowering treatment: prospective meta-analysis of data from 90,056 participants in 14 randomised trials of statins, Lancet source
- Not checked yetcites [99] Kearney, 2008, Efficacy of cholesterol-lowering therapy in 18,686 people with diabetes in 14 randomised trials of statins: a meta-analysis, Lancet source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“In addition, the Cholesterol Treatment Trialists ' Collaboration involving 26 statin trials, of which 5 compared high-intensity versus moderate-intensity statins (99), showed a 21% reduction in major cardiovascular events in people with diabetes for every 39 mg/dL of LDL cholesterol lowering, irrespective of baseline LDL cholesterol or patient characteristics (99).”
What the sources say
- Not checked yetcites [99] Kearney, 2008, Efficacy of cholesterol-lowering therapy in 18,686 people with diabetes in 14 randomised trials of statins: a meta-analysis, Lancet source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“In ARRIVE, with 12,546 patients over a period of 60 months follow-up, the primary end point occurred in 4.29% vs. 4.48% of patients in the aspirin versus placebo groups (HR 0.96 [95% CI 0.81 -1.13]; P = 0.60).”
What the sources say
- Not checked yetcites [145] Gaziano, 2018, Use of aspirin to reduce risk of initial vascular events in patients at moderate risk of cardiovascular disease (ARRIVE): a randomised, double-blind, placebo-controlled trial, Lancet source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“The combined end point of cardiovascular death, MI, or stroke was reduced by 20%, from 7.4 to 5.9% ( P < 0.001).”
What the sources say
- Not checked yetcites [108] Sabatine, 2017, Evolocumab and clinical outcomes in patients with cardiovascular disease, N Engl J Med source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“During a mean follow-up of 7.4 years, there was a signi fi cant 12% reduction in the primary ef fi cacy end point (8.5% vs. 9.6%; P = 0.01).”
What the sources say
- Not checked yetcites [144] ASCEND Study Collaborative Group, 2018, Effects of aspirin for primary prevention in persons with diabetes mellitus, N Engl J Med source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“Evolocumab reduced LDL cholesterol by 59% from a median of 92 to 30 mg/dL in the treatment arm.”
What the sources say
- Not checked yetcites [108] Sabatine, 2017, Evolocumab and clinical outcomes in patients with cardiovascular disease, N Engl J Med source
plaindirectn = 27,564- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“In those with diabetes (27% of participants), the combination of moderate-intensity simvastatin (40 mg) and ezetimibe (10 mg) showed a signi fi cant reduction of major adverse cardiovascular events with an absolute risk reduction of 5% (40% vs. 45% cumulative incidence at 7 years) and a relative risk reduction of 14% (hazard ratio [HR] 0.86 [95% CI 0.78 -0.94]) over moderateintensity simvastatin (”
What the sources say
- Not checked yetcites [109] Giugliano, 2018, Benefit of adding ezetimibe to statin therapy on cardiovascular outcomes and safety in patients with versus without diabetes mellitus: results from IMPROVE-IT (Improved Reduction of Outcomes: Vytorin Efficacy International Trial), Circulation source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“The largest reduction was for nonfatal MI, with little effect on CHD death (relative risk 0.95 [95% CI 0.78 -1.15]) or total stroke.”
What the sources say
- Not checked yetcites [139] Baigent, 2009, Aspirin in the primary and secondary prevention of vascular disease: collaborative meta-analysis of individual participant data from randomised trials, Lancet source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
None of the sources cited for this claim have been checked yet.
In the paper
“In primary prevention, however, among patients with no previous cardiovascular events, its net bene fi t is more controversial (129,140).”
What the sources say
- Not checked yetcites [129] Rajpathak, 2009, Statin therapy and risk of developing type 2 diabetes: a meta-analysis, Diabetes Care source
- Not checked yetcites [140] Perk, 2012, European Guidelines on cardiovascular disease prevention in clinical practice (version 2012). The Fifth Joint Task Force of the European Society of Cardiology and Other Societies on Cardiovascular Disease Prevention in Clinical Practice (constituted by representatives of nine societies and by invited experts), Eur Heart J source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
None of the sources cited for this claim have been checked yet.
In the paper
“Aspirin has been shown to be effective in reducing cardiovascular morbidity and mortality in high-risk patients with previous MI or stroke (secondary prevention) and is strongly recommended.”
What the sources say
- Not checked yetcites [129] Rajpathak, 2009, Statin therapy and risk of developing type 2 diabetes: a meta-analysis, Diabetes Care source
- Not checked yetcites [140] Perk, 2012, European Guidelines on cardiovascular disease prevention in clinical practice (version 2012). The Fifth Joint Task Force of the European Society of Cardiology and Other Societies on Cardiovascular Disease Prevention in Clinical Practice (constituted by representatives of nine societies and by invited experts), Eur Heart J source
boosteddirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
None of the sources cited for this claim have been checked yet.
In the paper
“Since asymptomatic people with diabetes with higher coronary disease burden have more future cardiac events (175,181,182), these additional imaging tests may provide reasoning for treatment intensi fi cation and/or guide informed patient decision-making and willingness for medication initiation and participation.”
What the sources say
- Not checked yetcites [175] Elkeles, 2008, Coronary calcium measurement improves prediction of cardiovascular events in asymptomatic patients with type 2 diabetes: the PREDICT study, Eur Heart J source
- Not checked yetcites [181] Hadamitzky, 2010, Prognostic value of coronary computed tomographic angiography in diabetic patients without known coronary artery disease, Diabetes Care source
- Not checked yetcites [182] Choi, 2009, Assessment of subclinical coronary atherosclerosis in asymptomatic patients with type 2 diabetes mellitus with single photon emission computed tomography and coronary computed tomography angiography, Am J Cardiol source
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“There is little evidence to support any speci fi c dose but using the lowest possible dose may help to reduce side effects (155).”
What the sources say
- Not checked yetcites [155] Campbell, 2007, Aspirin dose for the prevention of cardiovascular disease: a systematic review, JAMA source
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“However, for adults with ASCVD risk > 1% per year, the number of ASCVD events prevented will be similar to the number of episodes of bleeding induced, although these complications do not have equal effects on long-term health (147).”
What the sources say
- Not checked yetcites [147] Pignone, 2006, Aspirin, statins, or both drugs for the primary prevention of coronary heart disease events in men: a cost-utility analysis, Ann Intern Med source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“There is also some evidence that silent ischemia may reverse over time, adding to the controversy concerning aggressive screening strategies (174).”
What the sources say
- Not checked yetcites [174] Wackers, 2007, Resolution of asymptomatic myocardial ischemia in patients with type 2 diabetes in the Detection of Ischemia in Asymptomatic Diabetics (DIAD) study, Diabetes Care source
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“The speci fi c estimates for canagli fl ozin versus placebo on the primary composite cardiovascular outcome were HR 0.88 (95% CI 0.75 -1.03) for the CANVAS trial and 0.82 (0.66 -1.01) for CANVAS-R, with no heterogeneity found between trials.”
What the sources say
- Not checked yetcites [9] Neal, 2017, Canagliflozin and cardiovascular and renal events in type 2 diabetes, N Engl J Med source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
None of the sources cited for this claim have been checked yet.
In the paper
“In the COMPASS (Cardiovascular Outcomes for People Using Anticoagulation Strategies) trial of 27,395 individuals with established coronary artery disease and/or peripheral artery disease, aspirin plus rivaroxaban 2.5 mg twice daily was superior to aspirin plus placebo in the reduction of cardiovascular ischemic events including major adverse limb events.”
What the sources say
- Not checked yetcites [168] Bhatt, 2020, Role of combination antiplatelet and anticoagulation therapy in diabetes mellitus and cardiovascular disease: insights from the COMPASS trial, Circulation source
- Not checked yetcites [169] Connolly, 2018, Rivaroxaban with or without aspirin in patients with stable coronary artery disease: an international, randomised, double-blind, placebo-controlled trial, Lancet source
plaindirectn = 27,395- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“There is little evidence to support any speci fi c dose but using the lowest possible dose may help to reduce side effects (155).”
What the sources say
- Not checked yetcites [155] Campbell, 2007, Aspirin dose for the prevention of cardiovascular disease: a systematic review, JAMA source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
None of the sources cited for this claim have been checked yet.
In the paper
“For people > 70 years of age (with or without diabetes), the balance appears to have greater risk than bene fi t (144,146).”
What the sources say
- Not checked yetcites [144] ASCEND Study Collaborative Group, 2018, Effects of aspirin for primary prevention in persons with diabetes mellitus, N Engl J Med source
- Not checked yetcites [146] McNeil, 2018, Effect of aspirin on cardiovascular events and bleeding in the healthy elderly, N Engl J Med source
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“and cardiovascular death by 38% (absolute rate 3.7% vs. 5.9%, HR 0.62 [95% CI 0.49 -0.77]; P < 0.001) (8).”
What the sources say
- Not checked yetcites [8] Zinman, 2015, Empagliflozin, cardiovascular outcomes, and mortality in type 2 diabetes, N Engl J Med source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“It appears that 75 -162 mg/day is optimal.”
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“However, a higher incidence of major bleeding, including intracranial hemorrhage, was noted with dual antiplatelet therapy.”
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“The speci fi c estimates for canagli fl ozin versus placebo on the primary composite cardiovascular outcome were HR 0.88 (95% CI 0.75 -1.03) for the CANVAS trial and 0.82 (0.66 -1.01) for CANVAS-R, with no heterogeneity found between trials.”
What the sources say
- Not checked yetcites [9] Neal, 2017, Canagliflozin and cardiovascular and renal events in type 2 diabetes, N Engl J Med source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
None of the sources cited for this claim have been checked yet.
In the paper
“Studies have found that a risk factor-based approach to the initial diagnostic evaluation and subsequent follow-up for coronary artery disease fails to identify which people with type 2 diabetes will have silent ischemia on screening tests (179,180).”
What the sources say
- Not checked yetcites [179] Wackers, 2004, Detection of silent myocardial ischemia in asymptomatic diabetic subjects: the DIAD study, Diabetes Care source
- Not checked yetcites [180] Scognamiglio, 2006, Detection of coronary artery disease in asymptomatic patients with type 2 diabetes mellitus, J Am Coll Cardiol source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
None of the sources cited for this claim have been checked yet.
In the paper
“Similarly, the addition of ticagrelor to aspirin reduced the risk of ischemic cardiovascular events compared with aspirin alone in people with diabetes and stable coronary artery disease (164,165).”
What the sources say
- Not checked yetcites [164] Steg, 2019, Ticagrelor in patients with stable coronary disease and diabetes, N Engl J Med source
- Not checked yetcites [165] Bhatt, 2019, Ticagrelor in patients with diabetes and stable coronary artery disease with a history of previous percutaneous coronary intervention (THEMIS-PCI): a phase 3, placebo-controlled, randomised trial, Lancet source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“Rivaroxaban treatment in this group of patients was also associated with a signi fi cantly lower incidence of ischemic cardiovascular events, including major adverse limb events.”
What the sources say
- Not checked yetcites [170] Bonaca, 2020, Rivaroxaban in peripheral artery disease after revascularization, N Engl J Med source
plaincorrelationaln = 6,564- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“In ASPREE, including 19,114 individuals, for cardiovascular disease (fatal CHD, MI, stroke, or hospitalization for heart failure) after a median of 4.7 years of follow-up, the rates per 1,000 personyears were 10.7 vs. 11.3 events in aspirin vs. placebo groups (HR 0.95 [95% CI 0.83 -1.08]).”
What the sources say
- Not checked yetcites [146] McNeil, 2018, Effect of aspirin on cardiovascular events and bleeding in the healthy elderly, N Engl J Med source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“In 2008, the FDA issued a guidance for industry to perform cardiovascular outcomes trials for all new medications for the treatment for type 2 diabetes amid concerns of increased cardiovascular risk (192).”
What the sources say
- Not checked yetcites [192] U.S. Food and Drug Administration . Guidance for industry. Diabetes mellitus—evaluating cardiovascular risk in new antidiabetic therapies to treat type 2 diabetes. Silver Spring, MD, 2008. Accessed 21 October 2022. Available from https://www.federalregister.gov/documents/2008/12/19/E8-30086/guidance-for-industry-on-diabetes-mellitus-evaluating-cardiovascular-risk-in-new-antidiabetic
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“The speci fi c estimates for canagli fl ozin versus placebo on the primary composite cardiovascular outcome were HR 0.88 (95% CI 0.75 -1.03) for the CANVAS trial and 0.82 (0.66 -1.01) for CANVAS-R, with no heterogeneity found between trials.”
What the sources say
- Not checked yetcites [9] Neal, 2017, Canagliflozin and cardiovascular and renal events in type 2 diabetes, N Engl J Med source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“Many alternate pathways for platelet activation exist that are independent of thromboxane A2 and thus are not sensitive to the effects of aspirin (157).”
What the sources say
- Not checked yetcites [157] Davì, 2007, Platelet activation and atherothrombosis, N Engl J Med source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
None of the sources cited for this claim have been checked yet.
In the paper
“However, an increased risk of major bleeding was noted with rivaroxaban added to aspirin treatment in both COMPASS and VOYAGER PAD.”
What the sources say
- Not checked yetcites [168] Bhatt, 2020, Role of combination antiplatelet and anticoagulation therapy in diabetes mellitus and cardiovascular disease: insights from the COMPASS trial, Circulation source
- Not checked yetcites [169] Connolly, 2018, Rivaroxaban with or without aspirin in patients with stable coronary artery disease: an international, randomised, double-blind, placebo-controlled trial, Lancet source
- Not checked yetcites [170] Bonaca, 2020, Rivaroxaban in peripheral artery disease after revascularization, N Engl J Med source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“EMPA-REG OUTCOME showed that over a median follow-up of 3.1 years, treatment reduced the composite outcome of MI, stroke, and cardiovascular death by 14% (absolute rate 10.5% vs. 12.1% in the placebo group, HR in the empagli fl ozin group 0.86 [95% CI 0.74 -0.99]; P = 0.04 for superiority)”
What the sources say
- Not checked yetcites [8] Zinman, 2015, Empagliflozin, cardiovascular outcomes, and mortality in type 2 diabetes, N Engl J Med source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
None of the sources cited for this claim have been checked yet.
In the paper
“The absolute benefi ts of combination therapy appeared larger in people with diabetes, who comprised 10,341 of the trial participants (168,169).”
What the sources say
- Not checked yetcites [168] Bhatt, 2020, Role of combination antiplatelet and anticoagulation therapy in diabetes mellitus and cardiovascular disease: insights from the COMPASS trial, Circulation source
- Not checked yetcites [169] Connolly, 2018, Rivaroxaban with or without aspirin in patients with stable coronary artery disease: an international, randomised, double-blind, placebo-controlled trial, Lancet source
hedgedcorrelationaln = 10,341- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The main adverse effect is an increased risk of gastrointestinal bleeding.”
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“The excess risk may be as high as 5 per 1,000 per year in real-world settings.”
What the sources say
- Not checked yetcites [147] Pignone, 2006, Aspirin, statins, or both drugs for the primary prevention of coronary heart disease events in men: a cost-utility analysis, Ann Intern Med source
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
None of the sources cited for this claim have been checked yet.
In the paper
“these high-risk patients should already be receiving intensive medical therapy -an approach that provides benefi t similar to invasive revascularization (172,173).”
What the sources say
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“The rate of major hemorrhage per 1,000 person-years was 8.6 events vs. 6.2 events, respectively (HR 1.38 [95% CI 1.18 -1.62]; P < 0.001).”
What the sources say
- Not checked yetcites [146] McNeil, 2018, Effect of aspirin on cardiovascular events and bleeding in the healthy elderly, N Engl J Med source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“For people with documented ASCVD, use of aspirin for secondary prevention has far greater bene fi t than risk; for this indication, aspirin is still recommended (139).”
What the sources say
- Not checked yetcites [139] Baigent, 2009, Aspirin in the primary and secondary prevention of vascular disease: collaborative meta-analysis of individual participant data from randomised trials, Lancet source
boosteddirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Accordingly, indiscriminate screening is not considered cost-effective.”
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“In people with diabetes and prior MI (1 -3 years before), adding ticagrelor to aspirin signi fi cantly reduces the risk of recurrent ischemic events including cardiovascular and CHD death (163).”
What the sources say
- Not checked yetcites [163] Bhatt, 2016, Reduction in ischemic events with ticagrelor in diabetic patients with prior myocardial infarction in PEGASUS-TIMI 54, J Am Coll Cardiol source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“No difference was seen in cardiovascular death between groups.”
What the sources say
- Not checked yetcites [196] Wiviott, 2019, Dapagliflozin and cardiovascular outcomes in type 2 diabetes, N Engl J Med source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“After a median follow-up of 3.8 years, LEADER showed that the primary composite outcome (MI, stroke, or cardiovascular death) occurred in fewer participants in the treatment group (13.0%) when compared with the placebo group (14.9%) (HR 0.87 [95% CI 0.78 -0.97]; P < 0.001 for noninferiority; P = 0.01 for superiority).”
What the sources say
- Not checked yetcites [203] Marso, 2016, Liraglutide and cardiovascular outcomes in type 2 diabetes, N Engl J Med source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“as well as lower risk of hospitalizations for heart failure (HR 0.61 [95% CI 0.47 -0.80])”
What the sources say
- Not checked yetcites [194] Perkovic, 2019, Canagliflozin and renal outcomes in type 2 diabetes and nephropathy, N Engl J Med source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“DECLARE-TIMI 58 met the prespeci fi ed criteria for noninferiority to placebo with respect to major adverse cardiovascular events but did not show a lower rate of major adverse cardiovascular events when compared with placebo (8.8% in the dapagli fl ozin group and 9.4% in the placebo group; HR 0.93 [95% CI 0.84 -1.03]; P = 0.17).”
What the sources say
- Not checked yetcites [196] Wiviott, 2019, Dapagliflozin and cardiovascular outcomes in type 2 diabetes, N Engl J Med source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“Canagli fl ozin was additionally found to have a lower risk of the composite of cardiovascular death, MI, or stroke (HR 0.80 [95% CI 0.67 -0.95])”
What the sources say
- Not checked yetcites [194] Perkovic, 2019, Canagliflozin and renal outcomes in type 2 diabetes and nephropathy, N Engl J Med source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“After a median follow-up of 5.4 years, the primary composite outcome of nonfatal MI, nonfatal stroke, or death from cardiovascular causes occurred in 12.0% and 13.4% of participants in the dulaglutide and placebo treatment groups, respectively (HR 0.88 [95% CI 0.79 -0.99]; P = 0.026).”
What the sources say
- Not checked yetcites [207] Gerstein, 2019, Dulaglutide and cardiovascular outcomes in type 2 diabetes (REWIND): a double-blind, randomised placebo-controlled trial, Lancet source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“More patients discontinued treatment in the semaglutide group because of adverse events, mainly gastrointestinal.”
What the sources say
- Not checked yetcites [204] Marso, 2016, Semaglutide and cardiovascular outcomes in patients with type 2 diabetes, N Engl J Med source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“Over a median duration of 1.6 years, the GLP-1 receptor agonist reduced the risk of cardiovascular death, MI, or stroke to an incidence rate of 4.6 events per 100 person-years in the albiglutide group vs. 5.9 events in the placebo group (HR ratio 0.78, P = 0.0006 for superiority) (206).”
What the sources say
- Not checked yetcites [206] Hernandez, 2018, Albiglutide and cardiovascular outcomes in patients with type 2 diabetes and cardiovascular disease (Harmony Outcomes): a double-blind, randomised placebo-controlled trial, Lancet source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“Over a median follow-up period of 2.4 years, a primary outcome event occurred in 9.2% of participants in the dapagli fl ozin group and 14.5% of those in the placebo group.”
What the sources say
- Not checked yetcites [197] Heerspink, 2020, Dapagliflozin in patients with chronic kidney disease, N Engl J Med source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“as were the risks for a renal composite outcome of sustained decline in eGFR of at least 50%, endstage kidney disease, or death from renal causes (HR 0.56 [95% CI 0.45 -0.68])”
What the sources say
- Not checked yetcites [197] Heerspink, 2020, Dapagliflozin in patients with chronic kidney disease, N Engl J Med source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“A lower rate of cardiovascular death or hospitalization for heart failure was noted (4.9% vs. 5.8%; HR 0.83 [95% CI 0.73 -0.95]; P = 0.005), which re fl ected a lower rate of hospitalization for heart failure (HR 0.73 [95% CI 0.61 -0.88]).”
What the sources say
- Not checked yetcites [196] Wiviott, 2019, Dapagliflozin and cardiovascular outcomes in type 2 diabetes, N Engl J Med source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“and of the composite of cardiovascular death or hospitalization for heart failure (HR 0.69 [95% CI 0.57 -0.83])”
What the sources say
- Not checked yetcites [194] Perkovic, 2019, Canagliflozin and renal outcomes in type 2 diabetes and nephropathy, N Engl J Med source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“VERTIS CV met the prespeci fi ed criteria for noninferiority of ertugli fl ozin to placebo with respect to the primary outcome of major adverse cardiovascular events (11.9% in the pooled ertugli fl ozin group and 11.9% in the placebo group; HR 0.97 [95% CI 0.85 -1.11]; P < 0.001).”
What the sources say
- Not checked yetcites [201] Cannon, 2020, Cardiovascular outcomes with ertugliflozin in type 2 diabetes, N Engl J Med source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“The results were consistent across the subgroups of patients with and without history of CV events.”
What the sources say
- Not checked yetcites [207] Gerstein, 2019, Dulaglutide and cardiovascular outcomes in type 2 diabetes (REWIND): a double-blind, randomised placebo-controlled trial, Lancet source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“The risk of the primary composite outcome was 30% lower with canagli fl ozin treatment when compared with placebo (HR 0.70 [95% CI 0.59 -0.82]).”
What the sources say
- Not checked yetcites [194] Perkovic, 2019, Canagliflozin and renal outcomes in type 2 diabetes and nephropathy, N Engl J Med source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“The HR for a secondary outcome of hospitalization for heart failure (ertugli fl ozin vs. placebo) was 0.70 [95% CI 0.54 -0.90], consistent with fi ndings from other SGLT2 inhibitor cardiovascular outcomes trials.”
What the sources say
- Not checked yetcites [201] Cannon, 2020, Cardiovascular outcomes with ertugliflozin in type 2 diabetes, N Engl J Med source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“DECLARE-TIMI 58 met the prespeci fi ed criteria for noninferiority to placebo with respect to major adverse cardiovascular events but did not show a lower rate of major adverse cardiovascular events when compared with placebo (8.8% in the dapagli fl ozin group and 9.4% in the placebo group; HR 0.93 [95% CI 0.84 -1.03]; P = 0.17).”
What the sources say
- Not checked yetcites [196] Wiviott, 2019, Dapagliflozin and cardiovascular outcomes in type 2 diabetes, N Engl J Med source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“Allcause mortality did not differ between groups ( P = 0.067).”
What the sources say
- Not checked yetcites [207] Gerstein, 2019, Dulaglutide and cardiovascular outcomes in type 2 diabetes (REWIND): a double-blind, randomised placebo-controlled trial, Lancet source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“After a median of 16 months of follow-up, the rate of primary end point events was reduced with sotagli fl ozin (5.6 events per 100 patient-years in the sotagli fl ozin group and 7.5 events per 100 patient-years in the placebo group [HR 0.74 (95% CI 0.63 -0.88); P < 0.001]).”
What the sources say
- Not checked yetcites [202] Bhatt, 2021, Sotagliflozin in patients with diabetes and chronic kidney disease, N Engl J Med source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“but not the secondary end point of deaths from cardiovascular causes.”
What the sources say
- Not checked yetcites [202] Bhatt, 2021, Sotagliflozin in patients with diabetes and chronic kidney disease, N Engl J Med source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“The risk of the primary composite outcome was signi fi cantly lower with dapagli fl ozin therapy compared with placebo (HR 0.61 [95% CI 0.51 -0.72])”
What the sources say
- Not checked yetcites [197] Heerspink, 2020, Dapagliflozin in patients with chronic kidney disease, N Engl J Med source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“The primary outcome (the fi rst occurrence of cardiovascular death, nonfatal MI, or nonfatal stroke) occurred in 108 patients (6.6%) in the semaglutide group vs. 146 patients (8.9%) in the placebo group (HR 0.74 [95% CI 0.58 -0.95]; P < 0.001).”
What the sources say
- Not checked yetcites [204] Marso, 2016, Semaglutide and cardiovascular outcomes in patients with type 2 diabetes, N Engl J Med source
plaindirectn = 108- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“Of note, there was an increased risk of lower-limb amputation with canagli fl ozin (6.3 vs. 3.4 participants per 1,000 patient-years; HR 1.97 [95% CI 1.41 -2.75]) (9).”
What the sources say
- Not checked yetcites [9] Neal, 2017, Canagliflozin and cardiovascular and renal events in type 2 diabetes, N Engl J Med source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“Deaths from cardiovascular causes were signi fi cantly reduced in the liraglutide group (4.7%) compared with the placebo group (6.0%) (HR 0.78 [95% CI 0.66 -0.93]; P = 0.007) (203).”
What the sources say
- Not checked yetcites [203] Marso, 2016, Liraglutide and cardiovascular outcomes in type 2 diabetes, N Engl J Med source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“Moreover, it reduced the prespeci fi ed end point of end-stage kidney disease alone by 32% (HR 0.68 [95% CI 0.54 -0.86]).”
What the sources say
- Not checked yetcites [194] Perkovic, 2019, Canagliflozin and renal outcomes in type 2 diabetes and nephropathy, N Engl J Med source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“The primary outcome of cardiovascular death, MI, stroke, or hospitalization for unstable angina occurred in 406 patients (13.4%) in the lixisenatide group vs. 399 (13.2%) in the placebo group (HR 1.2 [95% CI 0.89 -1.17]), which demonstrated the noninferiority of lixisenatide to placebo ( P < 0.001) but did not show superiority ( P = 0.81).”
What the sources say
- Not checked yetcites [208] Pfeffer, 2015, Lixisenatide in patients with type 2 diabetes and acute coronary syndrome, N Engl J Med source
boostedn = 406- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“These fi ndings equated to incidence rates of 2.4 and 2.7 events per 100 person-years, respectively.”
What the sources say
- Not checked yetcites [207] Gerstein, 2019, Dulaglutide and cardiovascular outcomes in type 2 diabetes (REWIND): a double-blind, randomised placebo-controlled trial, Lancet source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“However, all-cause mortality was lower in the exenatide group (HR 0.86 [95% CI 0.77 -0.97]).”
What the sources say
- Not checked yetcites [209] Holman, 2017, Effects of once-weekly exenatide on cardiovascular outcomes in type 2 diabetes, N Engl J Med source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“A lower rate of cardiovascular death or hospitalization for heart failure was noted (4.9% vs. 5.8%; HR 0.83 [95% CI 0.73 -0.95]; P = 0.005), which re fl ected a lower rate of hospitalization for heart failure (HR 0.73 [95% CI 0.61 -0.88]).”
What the sources say
- Not checked yetcites [196] Wiviott, 2019, Dapagliflozin and cardiovascular outcomes in type 2 diabetes, N Engl J Med source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“The primary outcome of cardiovascular death, MI, stroke, or hospitalization for unstable angina occurred in 406 patients (13.4%) in the lixisenatide group vs. 399 (13.2%) in the placebo group (HR 1.2 [95% CI 0.89 -1.17]), which demonstrated the noninferiority of lixisenatide to placebo ( P < 0.001) but did not show superiority ( P = 0.81).”
What the sources say
- Not checked yetcites [208] Pfeffer, 2015, Lixisenatide in patients with type 2 diabetes and acute coronary syndrome, N Engl J Med source
boostedn = 406- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“The HR for a secondary outcome of hospitalization for heart failure (ertugli fl ozin vs. placebo) was 0.70 [95% CI 0.54 -0.90], consistent with fi ndings from other SGLT2 inhibitor cardiovascular outcomes trials.”
What the sources say
- Not checked yetcites [201] Cannon, 2020, Cardiovascular outcomes with ertugliflozin in type 2 diabetes, N Engl J Med source
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The EMPA-REG OUTCOME, CANVAS, DECLARE-TIMI 58, and CREDENCE trials suggested, but did not prove, that SGLT2 inhibitors would be bene fi cial in the treatment of people with established heart failure.”
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“The primary outcome of a composite of worsening heart failure, de fi ned as hospitalization or urgent visit for heart failure, or cardiovascular death was reduced by 18% in patients treated with dapagli fl ozin compared with placebo (HR 0.82 [95% CI 0.73 -0.92]; P < 0.001).”
What the sources say
- Not checked yetcites [199] Solomon, 2022, Dapagliflozin in heart failure with mildly reduced or preserved ejection fraction, N Engl J Med source
plaindirectn = 6,263- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“A large recent meta-analysis (227) including data from EMPEROR-Reduced, EMPEROR-Preserved, DAPA-HF, DELIVER, and Effect of Sotagli fl ozin on Cardiovascular Events in Patients With Type 2 Diabetes Post Worsening Heart Failure (SOLOISTWHF) included 21,947 patients and demonstrated reduced risk for the composite of cardiovascular death or hospitalization for heart failure, cardiovascular death, fi r”
What the sources say
- Not checked yetcites [227] Vaduganathan, 2022, SGLT-2 inhibitors in patients with heart failure: a comprehensive meta-analysis of five randomised controlled trials, Lancet source
boosteddirectn = 21,947- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
None of the sources cited for this claim have been checked yet.
In the paper
“Reduced incidence of heart failure has been observed with the use of SGLT2 inhibitors (8,194,196).”
What the sources say
- Not checked yetcites [8] Zinman, 2015, Empagliflozin, cardiovascular outcomes, and mortality in type 2 diabetes, N Engl J Med source
- Not checked yetcites [194] Perkovic, 2019, Canagliflozin and renal outcomes in type 2 diabetes and nephropathy, N Engl J Med source
- Not checked yetcites [196] Wiviott, 2019, Dapagliflozin and cardiovascular outcomes in type 2 diabetes, N Engl J Med source
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“Over a median of 18.2 months, the group assigned to dapagli fl ozin treatment had a lower risk of the primary outcome (HR 0.74 [95% CI 0.65 -0.85]), lower risk of fi rst worsening heart failure event (HR 0.70 [95% CI 0.59 -0.83]), and lower risk of cardiovascular death (HR 0.82 [95% CI 0.69 -0.98]) compared with placebo.”
What the sources say
- Not checked yetcites [11] McMurray, 2019, Dapagliflozin in patients with heart failure and reduced ejection fraction, N Engl J Med source
plaindirectn = 4,744- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“Over a median follow-up of 16 months, those in the empagli fl ozin-treated group had a reduced risk of the primary outcome (HR 0.75 [95% CI 0.65 -0.86]; P < 0.001) and fewer total hospitalizations for heart failure (HR 0.70 [95% CI 0.58 -0.85]; P < 0.001).”
What the sources say
- Not checked yetcites [200] Packer, 2020, Cardiovascular and renal outcomes with empagliflozin in heart failure, N Engl J Med source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“The effects of empagli fl ozin were consistent in people with or without diabetes (189).”
What the sources say
- Not checked yetcites [189] Anker, 2021, Empagliflozin in heart failure with a preserved ejection fraction, N Engl J Med source
plainn = 5,988- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“Restrictions to use of metformin in people with medically treated heart failure were removed by the FDA in 2006 (221).”
What the sources say
- Not checked yetcites [221] Inzucchi, 2007, Metformin in heart failure, Diabetes Care source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“Over a median of 26.2 months, there was a 21% reduction (HR 0.79 [95% CI 0.69 -0.90]; P < 0.001) of the primary outcome.”
What the sources say
- Not checked yetcites [189] Anker, 2021, Empagliflozin in heart failure with a preserved ejection fraction, N Engl J Med source
plaindirectn = 5,988- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“These combined fi ndings from four large outcomes trials of three different SGLT2 inhibitors are highly consistent and clearly indicate robust bene fi ts of SGLT2 inhibitors in the prevention of heart failure hospitalizations.”
boosteddirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“Importantly, the effects of efpeglenatide did not vary by use of SGLT2 inhibitors, suggesting that the bene fi cial effects of the GLP-1 receptor agonist were independent of those provided by SGLT2 inhibitor therapy (215).”
What the sources say
- Not checked yetcites [215] Lam, 2022, Efpeglenatide and clinical outcomes with and without concomitant sodium-glucose cotransporter-2 inhibition use in type 2 diabetes: exploratory analysis of the AMPLITUDE-O Trial, Circulation source
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“Observational studies of people with type 2 diabetes and heart failure suggest that metformin users have better outcomes than individuals treated with other antihyperglycemic agents (222); however, no randomized trial of metformin therapy has been conducted in people with heart failure.”
What the sources say
- Not checked yetcites [222] Eurich, 2005, Improved clinical outcomes associated with metformin in patients with diabetes and heart failure, Diabetes Care source
hedgedcorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Rests on an assumption: No randomized trial of metformin therapy has been conducted in people with heart failure.
In the paper
“The effect of empagli fl ozin on the primary outcome was consistent irrespective of diabetes diagnosis at baseline.”
What the sources say
- Not checked yetcites [200] Packer, 2020, Cardiovascular and renal outcomes with empagliflozin in heart failure, N Engl J Med source
plainn = 3,730- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“In addition, patients treated with empagli fl ozin were more likely to experience an improvement in NYHA functional class (229).”
What the sources say
- Not checked yetcites [229] Packer, 2021, Effect of empagliflozin on the clinical stability of patients with heart failure and a reduced ejection fraction: the EMPEROR-Reduced trial, Circulation source
hedgeddirectn = 3,730- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“Although the majority of patients in the study did not have heart failure at baseline, this benefi t was consistent in patients with and without a history of heart failure (10).”
What the sources say
- Not checked yetcites [10] Fitchett, 2018, Effects of empagliflozin on risk for cardiovascular death and heart failure hospitalization across the spectrum of heart failure risk in the EMPA-REG OUTCOME trial, Eur Heart J source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
None of the sources cited for this claim have been checked yet.
In the paper
“Emerging data suggest that use of both classes of drugs will provide an additive cardiovascular and kidney outcomes bene fi t; thus, combination therapy with an SGLT2 inhibitor and a GLP-1 receptor agonist may be considered to provide the complementary outcomes bene fi ts associated with these classes of medication.”
What the sources say
- Not checked yetcites [214] Gerstein, 2021, Cardiovascular and renal outcomes with efpeglenatide in type 2 diabetes, N Engl J Med source
- Not checked yetcites [215] Lam, 2022, Efpeglenatide and clinical outcomes with and without concomitant sodium-glucose cotransporter-2 inhibition use in type 2 diabetes: exploratory analysis of the AMPLITUDE-O Trial, Circulation source
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
None of the sources cited for this claim have been checked yet.
In the paper
“No increased risk of heart failure hospitalization has been identi fi ed in the cardiovascular outcomes trials of the GLP-1 receptor agonists lixisenatide, liraglutide, semaglutide, exenatide once-weekly, albiglutide, or dulaglutide compared with placebo ( Table 10.3 B ) (203,204,207 -209).”
What the sources say
- Not checked yetcites [203] Marso, 2016, Liraglutide and cardiovascular outcomes in type 2 diabetes, N Engl J Med source
- Not checked yetcites [204] Marso, 2016, Semaglutide and cardiovascular outcomes in patients with type 2 diabetes, N Engl J Med source
- Not checked yetcites [207] Gerstein, 2019, Dulaglutide and cardiovascular outcomes in type 2 diabetes (REWIND): a double-blind, randomised placebo-controlled trial, Lancet source
- Not checked yetcites [208] Pfeffer, 2015, Lixisenatide in patients with type 2 diabetes and acute coronary syndrome, N Engl J Med source
- Not checked yetcites [209] Holman, 2017, Effects of once-weekly exenatide on cardiovascular outcomes in type 2 diabetes, N Engl J Med source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“Approximately 44% of patients randomized to either dapaglifl ozin or placebo had type 2 diabetes, and results were consistent regardless of the presence of type 2 diabetes.”
What the sources say
- Not checked yetcites [199] Solomon, 2022, Dapagliflozin in heart failure with mildly reduced or preserved ejection fraction, N Engl J Med source
plainn = 6,263- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“The Saxagliptin Assessment of Vascular Outcomes Recorded in Patients with Diabetes Mellitus -Thrombolysis in Myocardial Infarction 53 (SAVOR-TIMI 53) study showed that patients treated with the DPP-4 inhibitor saxagliptin were more likely to be hospitalized for heart failure than those given placebo (3.5% vs. 2.8%, respectively) (224).”
What the sources say
- Not checked yetcites [224] Scirica, 2013, Saxagliptin and cardiovascular outcomes in patients with type 2 diabetes mellitus, N Engl J Med source
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
None of the sources cited for this claim have been checked yet.
In the paper
“and four FDA-approved GLP-1 receptor agonists (liraglutide, albiglutide [although that agent was removed from the market for business reasons], semaglutide [lower risk of cardiovascular events in a moderate-sized clinical trial but one not powered as a cardiovascular outcomes trial], and dulaglutide).”
What the sources say
- Not checked yetcites [203] Marso, 2016, Liraglutide and cardiovascular outcomes in type 2 diabetes, N Engl J Med source
- Not checked yetcites [204] Marso, 2016, Semaglutide and cardiovascular outcomes in patients with type 2 diabetes, N Engl J Med source
- Not checked yetcites [206] Hernandez, 2018, Albiglutide and cardiovascular outcomes in patients with type 2 diabetes and cardiovascular disease (Harmony Outcomes): a double-blind, randomised placebo-controlled trial, Lancet source
hedgeddirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“Over a median of 18.2 months, the group assigned to dapagli fl ozin treatment had a lower risk of the primary outcome (HR 0.74 [95% CI 0.65 -0.85]), lower risk of fi rst worsening heart failure event (HR 0.70 [95% CI 0.59 -0.83]), and lower risk of cardiovascular death (HR 0.82 [95% CI 0.69 -0.98]) compared with placebo.”
What the sources say
- Not checked yetcites [11] McMurray, 2019, Dapagliflozin in patients with heart failure and reduced ejection fraction, N Engl J Med source
plaindirectn = 4,744- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“In 3,730 patients with NYHA class II -IV heart failure with an ejection fraction of # 40%, treatment with empagli fl ozin reduced the combined risk of death, hospitalization for heart failure, or an emergent/urgent heart failure visit requiring intravenous treatment and reduced the total number of hospitalizations for heart failure requiring intensive care, a vasopressor or positive inotropic drug”
What the sources say
- Not checked yetcites [229] Packer, 2021, Effect of empagliflozin on the clinical stability of patients with heart failure and a reduced ejection fraction: the EMPEROR-Reduced trial, Circulation source
plaindirectn = 3,730- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
None of the sources cited for this claim have been checked yet.
In the paper
“Data on the effects of glucose-lowering agents on heart failure outcomes have demonstrated that thiazolidinediones have a strong and consistent relationship with increased risk of heart failure (218 -220).”
What the sources say
- Not checked yetcites [218] Dormandy, 2005, Secondary prevention of macrovascular events in patients with type 2 diabetes in the PROactive Study (PROspective pioglitAzone Clinical Trial In macroVascular Events): a randomised controlled trial, Lancet source
- Not checked yetcites [219] Singh, 2007, Long-term risk of cardiovascular events with rosiglitazone: a meta-analysis, JAMA source
- Not checked yetcites [220] Lincoff, 2007, Pioglitazone and risk of cardiovascular events in patients with type 2 diabetes mellitus: a meta-analysis of randomized trials, JAMA source
boostedcorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“Over a median of 18.2 months, the group assigned to dapagli fl ozin treatment had a lower risk of the primary outcome (HR 0.74 [95% CI 0.65 -0.85]), lower risk of fi rst worsening heart failure event (HR 0.70 [95% CI 0.59 -0.83]), and lower risk of cardiovascular death (HR 0.82 [95% CI 0.69 -0.98]) compared with placebo.”
What the sources say
- Not checked yetcites [11] McMurray, 2019, Dapagliflozin in patients with heart failure and reduced ejection fraction, N Engl J Med source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“In EMPAREG OUTCOME, the addition of empaglifl ozin to standard care led to a signi fi cant 35% reduction in hospitalization for heart failure compared with placebo (8).”
What the sources say
- Not checked yetcites [8] Zinman, 2015, Empagliflozin, cardiovascular outcomes, and mortality in type 2 diabetes, N Engl J Med source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“The effect of dapagli fl ozin on the primary outcome was consistent regardless of the presence or absence of type 2 diabetes (11).”
What the sources say
- Not checked yetcites [11] McMurray, 2019, Dapagliflozin in patients with heart failure and reduced ejection fraction, N Engl J Med source
plainn = 4,744- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“The risk of a prespeci fi ed renal composite outcome (chronic dialysis, renal transplantation, or a sustained reduction in eGFR) was lower in the empagli fl ozin group than in the placebo group (1.6% in the empaglifl ozin group vs. 3.1% in the placebo group; HR 0.50 [95% CI 0.32 -0.77]).”
What the sources say
- Not checked yetcites [200] Packer, 2020, Cardiovascular and renal outcomes with empagliflozin in heart failure, N Engl J Med source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“Finerenone, a selective nonsteroidal mineralocorticoid antagonist, has been shown in the Finerenone in Reducing Kidney Failure and Disease Progression in Diabetic Kidney Disease (FIDELIO-DKD) trial to improve CKD outcomes in people with type 2 diabetes with stage 3 or 4 CKD and severe albuminuria (233).”
What the sources say
- Not checked yetcites [233] Bakris, 2020, Effect of finerenone on chronic kidney disease outcomes in type 2 diabetes, N Engl J Med source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“In people hospitalized for acute de novo or decompensated chronic heart failure, initiation of empagli fl ozin treatment during hospitalization reduced the primary outcome of a composite of death from any cause, number of heart failure events and time to fi rst heart failure event, or a 5-point or greater difference in change from baseline in the Kansas City Cardiomyopathy Questionnaire Total Sym”
What the sources say
- Not checked yetcites [230] Voors, 2022, The SGLT2 inhibitor empagliflozin in patients hospitalized for acute heart failure: a multinational randomized trial, Nat Med source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“These collective studies indicate that fi nerenone improves cardiovascular and renal outcomes in people with type 2 diabetes.”
hedgeddirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“The HR of the primary outcome of cardiovascular death, nonfatal MI, nonfatal stroke, or hospitalization from heart failure was reduced by 13% in patients treated with fi nerenone.”
What the sources say
- Not checked yetcites [186] Pitt, 2021, Cardiovascular events with finerenone in kidney disease and type 2 diabetes, N Engl J Med source
plaindirectn = 7,437- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“Finally, canagli fl ozin improved heart failure symptoms assessed using the Kansas City Cardiomyopathy Questionnaire Total Symptom Score, irrespective of left ventricular ejection fraction or the presence of diabetes (231).”
What the sources say
- Not checked yetcites [231] Spertus, 2022, The SGLT2 inhibitor canagliflozin in heart failure: the CHIEF-HF remote, patient-centered randomized trial, Nat Med source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- It may state two separate claims as one. 72
- Probably not a substantial claim. 9
- The quote only partly states this claim. 4
None of the sources cited for this claim have been checked yet.
In the paper
“Although some variability in calibration exists in various subgroups, including by sex, race, and diabetes, the overall risk prediction does not differ in those with or without diabetes (13 -16), validating the use of risk calculators in people with diabetes.”
What the sources say
- Not checked yetcites [13] Blood Pressure Lowering Treatment Trialists’ Collaboration, 2014, Blood pressure-lowering treatment based on cardiovascular risk: a meta-analysis of individual patient data, Lancet source
- Not checked yetcites [14] Grundy, 2019, 2018 AHA/ACC/AACVPR/AAPA/ABC/ACPM/ADA/AGS/APhA/ASPC/NLA/PCNA guideline on the management of blood cholesterol: executive summary: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines, J Am Coll Cardiol source
- Not checked yetcites [15] Muntner, 2014, Validation of the atherosclerotic cardiovascular disease Pooled Cohort risk equations, JAMA source
- Not checked yetcites [16] DeFilippis, 2017, Risk score overestimation: the impact of individual cardiovascular risk factors and preventive therapies on the performance of the American Heart Association-American College of Cardiology-Atherosclerotic Cardiovascular Disease risk score in a modern multi-ethnic cohort, Eur Heart J
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“Moreover, numerous studies have shown that antihypertensive therapy reduces ASCVD events, heart failure, and microvascular complications.”
boosteddirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Rests on an assumption: Hypertension is a major risk factor for both ASCVD and microvascular complications.
None of the sources cited for this claim have been checked yet.
In the paper
“Recently, risk scores and other cardiovascular biomarkers have been developed for risk strati fi cation of secondary prevention patients (i.e., those who are already high risk because they have ASCVD) but are not yet in widespread use (17,18).”
What the sources say
- Not checked yetcites [17] Bohula, 2017, Atherothrombotic risk stratification and ezetimibe for secondary prevention, J Am Coll Cardiol source
- Not checked yetcites [18] Bohula, 2016, Atherothrombotic risk stratification and the efficacy and safety of vorapaxar in patients with stable ischemic heart disease and previous myocardial infarction, Circulation source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“A recent meta-analysis indicated that SGLT2 inhibitors reduce the risk of heart failure hospitalization, cardiovascular mortality, and all-cause mortality in people with (secondary prevention) and without (primary prevention) cardiovascular disease (12).”
What the sources say
- Not checked yetcites [12] Arnott, 2020, Sodium-glucose cotransporter 2 inhibition for the prevention of cardiovascular events in patients with type 2 diabetes mellitus: a systematic review and meta-analysis, J Am Heart Assoc source
hedgeddirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Hypertension is often a precursor of heart failure of either type, and ASCVD can coexist with either type (7), whereas prior myocardial infarction (MI) is often a major factor in HFrEF.”
What the sources say
- Not checked yetcites [7] Lam, 2018, Heart failure with preserved ejection fraction: from mechanisms to therapies, Eur Heart J source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“these risk calculators do not account for the duration of diabetes or the presence of diabetes complications, such as albuminuria.”
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“An analysis of trials including people with type 2 diabetes and impaired glucose tolerance with achieved systolic blood pressures of < 135 mmHg in the intensive blood pressure treatment group and < 140 mmHg in the standard treatment group revealed a 10% reduction in all-cause mortality and a 17% reduction in stroke (30).”
What the sources say
- Not checked yetcites [30] Bangalore, 2011, Blood pressure targets in subjects with type 2 diabetes mellitus/impaired fasting glucose: observations from traditional and bayesian random-effects meta-analyses of randomized trials, Circulation source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“The cardiovascular event rates, de fi ned as fatal or nonfatal MI, fatal and nonfatal strokes, and all other cardiovascular events, were not signi fi cantly different between diastolic blood pressure targets ( # 90 mmHg, # 85 mmHg, and # 80 mmHg), although the lowest incidence of cardiovascular events occurred with an achieved diastolic blood pressure of 82 mmHg.”
What the sources say
- Not checked yetcites [37] Hansson, 1998, Effects of intensive blood-pressure lowering and low-dose aspirin in patients with hypertension: principal results of the Hypertension Optimal Treatment (HOT) randomised trial, Lancet source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“The results have been interpreted to be generally consistent between both trials, but ACCORD BP was viewed as underpowered due to the composite primary end point being less sensitive to blood pressure regulation (33).”
What the sources say
- Not checked yetcites [33] Wright, 2015, A randomized trial of intensive versus standard blood-pressure control, N Engl J Med source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“More intensive reduction to < 130 mmHg was associated with a further reduction in stroke but not other cardiovascular events.”
What the sources say
- Not checked yetcites [30] Bangalore, 2011, Blood pressure targets in subjects with type 2 diabetes mellitus/impaired fasting glucose: observations from traditional and bayesian random-effects meta-analyses of randomized trials, Circulation source
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Hypotension occurred more frequently in the intensive treatment group (3.4%) compared with the standard treatment group (2.6%), without signi fi cant differences in other adverse events, including dizziness, syncope, or fractures.”
What the sources say
- Not checked yetcites [34] Zhang, 2021, Trial of intensive blood-pressure control in older patients with hypertension, N Engl J Med source
plainn = 8,511- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Moreover, home blood pressure monitoring may improve patient medication taking and thus help reduce cardiovascular risk (25).”
What the sources say
- Not checked yetcites [25] Omboni, 2013, Clinical usefulness and cost effectiveness of home blood pressure telemonitoring: meta-analysis of randomized controlled studies, J Hypertens source
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“Among trials with lower baseline or attained blood pressure, antihypertensive treatment reduced the risk of stroke, retinopathy, and albuminuria, but effects on other ASCVD outcomes and heart failure were not evident.”
What the sources say
- Not checked yetcites [19] Whelton, 2018, 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA guideline for the prevention, detection, evaluation, and management of high blood pressure in adults: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines, J Am Coll Cardiol source
- Not checked yetcites [26] Emdin, 2015, Blood pressure lowering in type 2 diabetes: a systematic review and meta-analysis, JAMA source
- Not checked yetcites [27] Arguedas, 2013, Blood pressure targets for hypertension in people with diabetes mellitus, Cochrane Database Syst Rev
- Not checked yetcites [29] Brunström, 2016, Effect of antihypertensive treatment at different blood pressure levels in patients with diabetes mellitus: systematic review and meta-analyses, BMJ source
- Not checked yetcites [30] Bangalore, 2011, Blood pressure targets in subjects with type 2 diabetes mellitus/impaired fasting glucose: observations from traditional and bayesian random-effects meta-analyses of randomized trials, Circulation source
- Not checked yetcites [31] Thomopoulos, 2017, Effects of blood-pressure-lowering treatment on outcome incidence in hypertension: 10 - Should blood pressure management differ in hypertensive patients with and without diabetes mellitus? Overview and meta-analyses of randomized trials, J Hypertens source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“Randomized clinical trials have demonstrated unequivocally that treatment of hypertension reduces cardiovascular events as well as microvascular complications (26 -32).”
What the sources say
- Not checked yetcites [26] Emdin, 2015, Blood pressure lowering in type 2 diabetes: a systematic review and meta-analysis, JAMA source
- Not checked yetcites [27] Arguedas, 2013, Blood pressure targets for hypertension in people with diabetes mellitus, Cochrane Database Syst Rev
- Not checked yetcites [28] Ettehad, 2016, Blood pressure lowering for prevention of cardiovascular disease and death: a systematic review and meta-analysis, Lancet source
- Not checked yetcites [29] Brunström, 2016, Effect of antihypertensive treatment at different blood pressure levels in patients with diabetes mellitus: systematic review and meta-analyses, BMJ source
- Not checked yetcites [30] Bangalore, 2011, Blood pressure targets in subjects with type 2 diabetes mellitus/impaired fasting glucose: observations from traditional and bayesian random-effects meta-analyses of randomized trials, Circulation source
- Not checked yetcites [31] Thomopoulos, 2017, Effects of blood-pressure-lowering treatment on outcome incidence in hypertension: 10 - Should blood pressure management differ in hypertensive patients with and without diabetes mellitus? Overview and meta-analyses of randomized trials, J Hypertens source
- Not checked yetcites [32] Xie, 2016, Effects of intensive blood pressure lowering on cardiovascular and renal outcomes: updated systematic review and meta-analysis, Lancet source
boosteddirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Rests on an assumption: Hypertension is a major risk factor for both ASCVD and microvascular complications.
In the paper
“While the ACCORD (Action to Control Cardiovascular Risk in Diabetes) blood pressure trial (ACCORD BP) did not con fi rm that targeting a systolic blood pressure of < 120 mmHg in people with diabetes results in decreased cardiovascular event rates, the prespecifi ed secondary outcome of stroke was reduced by 41% with intensive treatment (35).”
What the sources say
- Not checked yetcites [35] Cushman, 2010, Effects of intensive blood-pressure control in type 2 diabetes mellitus, N Engl J Med source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“Of note, the ACCORD BP and SPRINT trials targeted a similar systolic blood pressure < 120 mmHg, but in contrast to SPRINT, the primary composite cardiovascular end point was nonsigni fi cantly reduced in ACCORD BP.”
What the sources say
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“This approach acknowledges that the bene fi ts and risks of intensive blood pressure targets are uncertain and may vary across patients and is consistent with a patient-focused approach to care that values patient priorities and health care professional judgment (39).”
What the sources say
- Not checked yetcites [39] de Boer, 2018, Individualizing blood pressure targets for people with diabetes and hypertension: comparing the ADA and the ACC/AHA recommendations, JAMA source
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“The Systolic Blood Pressure Intervention Trial (SPRINT) demonstrated that treatment to a target systolic blood pressure of < 120 mmHg decreases cardiovascular event rates by 25% in high-risk patients, although people with diabetes were excluded from this trial (33).”
What the sources say
- Not checked yetcites [33] Wright, 2015, A randomized trial of intensive versus standard blood-pressure control, N Engl J Med source
boosteddirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“One of the largest meta-analyses included 73,913 people with diabetes. Compared with a less tight blood pressure control, allocation to a tighter blood pressure control signi fi cantly reduced the risk of stroke by 31% but did not reduce the risk of MI (38).”
What the sources say
- Not checked yetcites [38] Reboldi, 2011, Effects of intensive blood pressure reduction on myocardial infarction and stroke in diabetes: a meta-analysis in 73,913 patients, J Hypertens source
plaindirectn = 73,913- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“In this trial, 18.9% of patients in the intensive treatment arm and 19.4% in the standard treatment arm had a diagnosis of type 2 diabetes.”
What the sources say
- Not checked yetcites [34] Zhang, 2021, Trial of intensive blood-pressure control in older patients with hypertension, N Engl J Med source
plainn = 8,511- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
None of the sources cited for this claim have been checked yet.
In the paper
“Lifestyle modi fi cation focusing on weight loss (if indicated); application of a Mediterranean or Dietary Approaches to Stop Hypertension (DASH) eating pattern; reduction of saturated fat and trans fat; increase of dietary n-3 fatty acids, viscous fi ber, and plant stanols/sterols intake; and increased physical activity should be recommended to improve the lipid pro fi le and reduce the risk of d”
What the sources say
- Not checked yetcites [83] Mehdi, 2009, Addition of angiotensin receptor blockade or mineralocorticoid antagonism to maximal angiotensin-converting enzyme inhibition in diabetic nephropathy, J Am Soc Nephrol source
- Not checked yetcites [86] Eckel, 2013, 2013 AHA/ACC guideline on lifestyle management to reduce cardiovascular risk: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines, Circulation
- Not checked yetcites [87] Arnett, 2019, 2019 ACC/AHA guideline on the primary prevention of cardiovascular disease: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines, Circulation
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
In the paper
“The American College of Obstetricians and Gynecologists also recommends that postpartum individuals with gestational hypertension, preeclampsia, and superimposed preeclampsia have their blood pressures observed for 72 h in the hospital and for 7 -10 days postpartum.”
What the sources say
- Not checked yetcites [51] Irgens, 2001, Long term mortality of mothers and fathers after pre-eclampsia: population based cohort study, BMJ source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Current evidence supports controlling blood pressure to 110 -135/85 mmHg to reduce the risk of accelerated maternal hypertension but also to minimize impairment of fetal growth.”
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“The mean systolic blood pressure achieved in the more intensively treated group was 133.1 ± 0.5 mmHg, and the mean diastolic blood pressure achieved in that group was 85.3 ± 0.3 mmHg.”
What the sources say
- Not checked yetcites [46] Magee, 2015, Less-tight versus tight control of hypertension in pregnancy, N Engl J Med source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Lifestyle management is an important component of hypertension treatment because it lowers blood pressure, enhances the effectiveness of some antihypertensive medications, promotes other aspects of metabolic and vascular health, and generally leads to few adverse effects.”
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“In CHIPS, targeting a diastolic blood pressure of 85 mmHg during pregnancy was associated with reduced likelihood of developing accelerated maternal hypertension and no demonstrable adverse outcome for infants compared with targeting a higher diastolic blood pressure.”
What the sources say
- Not checked yetcites [46] Magee, 2015, Less-tight versus tight control of hypertension in pregnancy, N Engl J Med source
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“Initial treatment for hypertension should include any of the drug classes demonstrated to reduce cardiovascular events in people with diabetes: ACE inhibitors (60,61), ARBs (60,61), thiazide-like diuretics (62), or dihydropyridine calcium channel blockers (63).”
What the sources say
- Not checked yetcites [60] Catalá-López, 2016, Cardiovascular and renal outcomes of renin-angiotensin system blockade in adult patients with diabetes mellitus: a systematic review with network meta-analyses, PLoS Med source
- Not checked yetcites [61] Palmer, 2015, Comparative efficacy and safety of blood pressure-lowering agents in adults with diabetes and kidney disease: a network meta-analysis, Lancet source
- Not checked yetcites [62] Barzilay, 2004, Cardiovascular outcomes using doxazosin vs. chlorthalidone for the treatment of hypertension in older adults with and without glucose disorders: a report from the ALLHAT study, J Clin Hypertens (Greenwich) source
- Not checked yetcites [63] Weber, 2010, Cardiovascular events during differing hypertension therapies in patients with diabetes, J Am Coll Cardiol source
boosteddirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Antihypertensive drugs known to be effective and safe in pregnancy include methyldopa, labetalol, and long-acting nifedipine, while hydralzine may be considered in the acute management of hypertension in pregnancy or severe preeclampsia (49).”
What the sources say
- Not checked yetcites [49] American College of Obstetricians and Gynecologists, Task Force on Hypertension in Pregnancy, 2013, Hypertension in pregnancy. Report of the American College of Obstetricians and Gynecologists’ Task Force on Hypertension in Pregnancy, Obstet Gynecol
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“A similar approach is supported by the International Society for the Study of Hypertension in Pregnancy, which speci fi cally recommends use of antihypertensive therapy to maintain systolic blood pressure between 110 and 140 mmHg and diastolic blood pressure between 80 and 85 mmHg (47).”
What the sources say
- Not checked yetcites [47] Brown, 2018, Hypertensive disorders of pregnancy: ISSHP classification, diagnosis, and management recommendations for international practice, Hypertension source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
None of the sources cited for this claim have been checked yet.
In the paper
“Treatment with ACE inhibitors or ARBs can cause AKI and hyperkalemia, while diuretics can cause AKI and either hypokalemia or hyperkalemia (depending on mechanism of action) (77,78).”
What the sources say
- Not checked yetcites [77] Nilsson, 2017, Incidence and determinants of hyperkalemia and hypokalemia in a large healthcare system, Int J Cardiol source
- Not checked yetcites [78] Bandak, 2017, Hyperkalemia after initiating renin-angiotensin system blockade: the Stockholm Creatinine Measurements (SCREAM) project, J Am Heart Assoc source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Detection and management of these abnormalities is important because AKI and hyperkalemia each increase the risks of cardiovascular events and death (79).”
What the sources say
- Not checked yetcites [79] Hughes-Austin, 2017, The relation of serum potassium concentration with cardiovascular events and mortality in community-living individuals, Clin J Am Soc Nephrol source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Intervention reduced risk of primary composite end point of major macrovascular and microvascular events (9%), death from any cause (14%), and death from CVD (18%)”
What the sources say
- Not checked yetcites [36] Patel, 2007, Effects of a fixed combination of perindopril and indapamide on macrovascular and microvascular outcomes in patients with type 2 diabetes mellitus (the ADVANCE trial): a randomised controlled trial, Lancet source
plaindirectn = 11,140- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“However, the use of both ACE inhibitors and ARBs in combination, or the combination of an ACE inhibitor or ARB and a direct renin inhibitor, is contraindicated given the lack of added ASCVD bene fi t and increased rate of adverse events -namely, hyperkalemia, syncope, and acute kidney injury (AKI) (71 -73).”
What the sources say
- Not checked yetcites [71] Yusuf, 2008, Telmisartan, ramipril, or both in patients at high risk for vascular events, N Engl J Med source
- Not checked yetcites [72] Fried, 2013, Combined angiotensin inhibition for the treatment of diabetic nephropathy, N Engl J Med source
- Not checked yetcites [73] Makani, 2013, Efficacy and safety of dual blockade of the renin-angiotensin system: meta-analysis of randomised trials, BMJ source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“Treatment with ACE inhibitors or ARBs can cause AKI and hyperkalemia, while diuretics can cause AKI and either hypokalemia or hyperkalemia (depending on mechanism of action) (77,78).”
What the sources say
- Not checked yetcites [77] Nilsson, 2017, Incidence and determinants of hyperkalemia and hypokalemia in a large healthcare system, Int J Cardiol source
- Not checked yetcites [78] Bandak, 2017, Hyperkalemia after initiating renin-angiotensin system blockade: the Stockholm Creatinine Measurements (SCREAM) project, J Am Heart Assoc source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Meta-analyses, including data from over 18,000 people with diabetes from 14 randomized trials of statin therapy (mean follow-up 4.3 years), demonstrate a 9% proportional reduction in all-cause mortality and 13% reduction in vascular mortality for each 1 mmol/L (39 mg/dL) reduction in LDL cholesterol (99).”
What the sources say
- Not checked yetcites [99] Kearney, 2008, Efficacy of cholesterol-lowering therapy in 18,686 people with diabetes in 14 randomised trials of statins: a meta-analysis, Lancet source
boosteddirectn = 18,000- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“These large trials included a signi fi cant number of participants with diabetes and prespeci fi ed analyses on cardiovascular outcomes in people with and without diabetes (109,111,112).”
What the sources say
- Not checked yetcites [109] Giugliano, 2018, Benefit of adding ezetimibe to statin therapy on cardiovascular outcomes and safety in patients with versus without diabetes mellitus: results from IMPROVE-IT (Improved Reduction of Outcomes: Vytorin Efficacy International Trial), Circulation source
- Not checked yetcites [111] Ray, 2019, Effects of alirocumab on cardiovascular and metabolic outcomes after acute coronary syndrome in patients with or without diabetes: a prespecified analysis of the ODYSSEY OUTCOMES randomised controlled trial, Lancet Diabetes Endocrinol source
- Not checked yetcites [112] Sabatine, 2017, Cardiovascular safety and efficacy of the PCSK9 inhibitor evolocumab in patients with and without diabetes and the effect of evolocumab on glycaemia and risk of new-onset diabetes: a prespecified analysis of the FOURIER randomised controlled trial, Lancet Diabetes Endocrinol source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“During the median follow-up of 2.2 years, the composite outcome of cardiovascular death, MI, stroke, hospitalization for angina, or revascularization occurred in 11.3% vs. 9.8% of the placebo and evolocumab groups, respectively, representing a 15% relative risk reduction (P < 0.001).”
What the sources say
- Not checked yetcites [108] Sabatine, 2017, Evolocumab and clinical outcomes in patients with cardiovascular disease, N Engl J Med source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“The cardiovascular bene fi t in this large meta-analysis did not depend on baseline LDL cholesterol levels and was linearly related to the LDL cholesterol reduction without a low threshold beyond which there was no bene fi t observed (99).”
What the sources say
- Not checked yetcites [99] Kearney, 2008, Efficacy of cholesterol-lowering therapy in 18,686 people with diabetes in 14 randomised trials of statins: a meta-analysis, Lancet source
plaincorrelationaln = 18,000- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“In contrast, major bleeding was signi fi cantly increased from 3.2 to 4.1% in the aspirin group (rate ratio 1.29; P = 0.003), with most of the excess being gastrointestinal bleeding and other extracranial bleeding.”
What the sources say
- Not checked yetcites [144] ASCEND Study Collaborative Group, 2018, Effects of aspirin for primary prevention in persons with diabetes mellitus, N Engl J Med source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“As in those without diabetes, absolute reductions in ASCVD outcomes (CHD death and nonfatal MI) are greatest in people with high baseline ASCVD risk (known ASCVD and/or very high LDL cholesterol levels), but the overall benefi ts of statin therapy in people with diabetes at moderate or even low risk for ASCVD are convincing (100,101).”
What the sources say
- Not checked yetcites [100] Taylor, 2013, Statins for the primary prevention of cardiovascular disease, Cochrane Database Syst Rev
- Not checked yetcites [101] Carter, 2013, Risk of incident diabetes among patients treated with statins: population based study, BMJ source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“Because cardiovascular event rates are increased in people with diabetes and established ASCVD, intensive therapy is indicated and has been shown to be of bene fi t in multiple large meta-analyses and randomized cardiovascular outcomes trials (91,99,105,107,108).”
What the sources say
- Not checked yetcites [91] Baigent, 2005, Efficacy and safety of cholesterol-lowering treatment: prospective meta-analysis of data from 90,056 participants in 14 randomised trials of statins, Lancet source
- Not checked yetcites [99] Kearney, 2008, Efficacy of cholesterol-lowering therapy in 18,686 people with diabetes in 14 randomised trials of statins: a meta-analysis, Lancet source
- Not checked yetcites [105] Cannon, 2015, Ezetimibe added to statin therapy after acute coronary syndromes, N Engl J Med source
- Not checked yetcites [107] Cannon, 2004, Intensive versus moderate lipid lowering with statins after acute coronary syndromes, N Engl J Med source
- Not checked yetcites [108] Sabatine, 2017, Evolocumab and clinical outcomes in patients with cardiovascular disease, N Engl J Med source
boosteddirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Accordingly, statins are the drugs of choice for LDL cholesterol lowering and cardioprotection.”
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. It may state two separate claims as one.
In the paper
“Overall, the addition of ezetimibe led to a 6.4% relative bene fi t and a 2% absolute reduction in major adverse cardiovascular events (atherosclerotic cardiovascular events), with the degree of bene fi t being directly proportional to the change in LDL cholesterol, which was 70 mg/dL in the statin group on average and 54 mg/dL in the combination group (105).”
What the sources say
- Not checked yetcites [105] Cannon, 2015, Ezetimibe added to statin therapy after acute coronary syndromes, N Engl J Med source
plaindirectn = 18,144- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“There were no signi fi cant differences by sex, weight, or duration of diabetes or other baseline factors including ASCVD risk score.”
What the sources say
- Not checked yetcites [144] ASCEND Study Collaborative Group, 2018, Effects of aspirin for primary prevention in persons with diabetes mellitus, N Engl J Med source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Evolocumab therapy also signi fi cantly reduced all strokes (1.5% vs. 1.9%; HR 0.79 [95% CI 0.66 -0.95]; P = 0.01) and ischemic stroke (1.2% vs. 1.6%; HR 0.75 [95% CI 0.62 -0.92]; P = 0.005) in the total population, with fi ndings being consistent in individuals with or without a history of ischemic stroke at baseline (115).”
What the sources say
- Not checked yetcites [115] Giugliano, 2020, Stroke prevention with the PCSK9 (proprotein convertase subtilisin-kexin type 9) inhibitor evolocumab added to statin in high-risk patients with stable atherosclerosis, Stroke source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“The net clinical bene fi t (ischemic bene fi t vs. bleeding risk) was improved with ticagrelor therapy in the large prespecifi ed subgroup of patients with history of percutaneous coronary intervention, while no net benefi t was seen in patients without prior percutaneous coronary intervention (165).”
What the sources say
- Not checked yetcites [165] Bhatt, 2019, Ticagrelor in patients with diabetes and stable coronary artery disease with a history of previous percutaneous coronary intervention (THEMIS-PCI): a phase 3, placebo-controlled, randomised trial, Lancet source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“A trial suggested that more frequent dosing regimens of aspirin may reduce platelet reactivity in individuals with diabetes (160); however, these observations alone are insuf fi cient to empirically recommend that higher doses of aspirin be used in this group at this time.”
What the sources say
- Not checked yetcites [160] Bethel, 2016, Randomized controlled trial comparing impact on platelet reactivity of twice-daily with once-daily aspirin in people with type 2 diabetes, Diabet Med source
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“Another meta-analysis raised the hypothesis that low-dose aspirin ef fi cacy is reduced in those weighing > 70 kg (161); however, the ASCEND trial found bene fi t of low-dose aspirin in those in this weight range, which would thus not validate this suggested hypothesis (144).”
What the sources say
- Not checked yetcites [161] Rothwell, 2018, Effects of aspirin on risks of vascular events and cancer according to bodyweight and dose: analysis of individual patient data from randomised trials, Lancet source
hedgedconditional- Asserted: fails — The authors may not put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The authors may not put it forward as true. The paper’s conclusions may not depend on it.
In the paper
“In addition, the CAROLINA (Cardiovascular Outcome Study of Linagliptin Versus Glimepiride in Type 2 Diabetes) study demonstrated noninferiority between a DPP-4 inhibitor, linagliptin, and a sulfonylurea, glimepiride, on cardiovascular outcomes despite lower rates of hypoglycemia in the linagliptin treatment group (193).”
What the sources say
- Not checked yetcites [193] Rosenstock, 2019, Effect of linagliptin vs placebo on major cardiovascular events in adults with type 2 diabetes and high cardiovascular and renal risk: the CARMELINA randomized clinical trial, JAMA source
boosteddirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“The combined analysis of the two trials found that canagli fl ozin signi fi cantly reduced the composite outcome of cardiovascular death, MI, or stroke versus placebo (occurring in 26.9 vs. 31.5 participants per 1,000 patient-years; HR 0.86 [95% CI 0.75 -0.97]).”
What the sources say
- Not checked yetcites [9] Neal, 2017, Canagliflozin and cardiovascular and renal events in type 2 diabetes, N Engl J Med source
plaindirectn = 1,000- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Another meta-analysis raised the hypothesis that low-dose aspirin ef fi cacy is reduced in those weighing > 70 kg (161); however, the ASCEND trial found bene fi t of low-dose aspirin in those in this weight range, which would thus not validate this suggested hypothesis (144).”
What the sources say
- Not checked yetcites [144] ASCEND Study Collaborative Group, 2018, Effects of aspirin for primary prevention in persons with diabetes mellitus, N Engl J Med source
hedgeddirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“In the ADAPTABLE (Aspirin Dosing: A Patient-Centric Trial Assessing Benefi ts and Long-term Effectiveness) trial of individuals with established cardiovascular disease, 38% of whom had diabetes, there were no signi fi cant differences in cardiovascular events or major bleeding between patients assigned to 81 mg and those assigned to 325 mg of aspirin daily (156).”
What the sources say
- Not checked yetcites [156] Jones, 2021, Comparative effectiveness of aspirin dosing in cardiovascular disease, N Engl J Med source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Thus, aspirin appears to have a modest effect on ischemic vascular events, with the absolute decrease in events depending on the underlying ASCVD risk.”
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Despite abnormal myocardial perfusion imaging in more than one in fi ve patients, cardiac outcomes were essentially equal (and very low) in screened versus unscreened patients.”
What the sources say
- Not checked yetcites [178] Young, 2009, Cardiac outcomes after screening for asymptomatic coronary artery disease in patients with type 2 diabetes: the DIAD study: a randomized controlled trial, JAMA source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Previously approved diabetes medications were not subject to the guidance.”
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“The CANVAS trial that started in 2009 was partially unblinded prior to completion because of the need to fi le interim cardiovascular outcomes data for regulatory approval of the drug (195).”
What the sources say
- Not checked yetcites [195] Neal, 2017, Rationale, design and baseline characteristics of the CANagliflozin cardioVascular Assessment Study-Renal (CANVAS-R): A randomized, placebo-controlled trial, Diabetes Obes Metab source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“Evidence supports use of either ticagrelor or clopidogrel if no percutaneous coronary intervention was performed and clopidogrel, ticagrelor , or prasugrel if a percutaneous coronary intervention was performed (162).”
What the sources say
- Not checked yetcites [162] Vandvik, 2012, Primary and secondary prevention of cardiovascular disease: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines, Chest source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“In prospective studies, coronary artery calcium has been established as an independent predictor of future ASCVD events in people with diabetes and is consistently superior to both the UK Prospective Diabetes Study (UKPDS) risk engine and the Framingham Risk Score in predicting risk in this population (175 -177).”
What the sources say
- Not checked yetcites [175] Elkeles, 2008, Coronary calcium measurement improves prediction of cardiovascular events in asymptomatic patients with type 2 diabetes: the PREDICT study, Eur Heart J source
- Not checked yetcites [176] Raggi, 2004, Prognostic value of coronary artery calcium screening in subjects with and without diabetes, J Am Coll Cardiol source
- Not checked yetcites [177] Anand, 2006, Risk stratification in uncomplicated type 2 diabetes: prospective evaluation of the combined use of coronary artery calcium imaging and selective myocardial perfusion scintigraphy, Eur Heart J source
boostedcorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“The effects of dapagli fl ozin therapy were similar in individuals with and without type 2 diabetes.”
What the sources say
- Not checked yetcites [197] Heerspink, 2020, Dapagliflozin in patients with chronic kidney disease, N Engl J Med source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
The quote only partly states this claim.
In the paper
“The trial was stopped early due to conclusive evidence of ef fi cacy identi fi ed during a prespeci fi ed interim analysis with no unexpected safety signals.”
What the sources say
- Not checked yetcites [194] Perkovic, 2019, Canagliflozin and renal outcomes in type 2 diabetes and nephropathy, N Engl J Med source
boosteddirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“No signi fi cant between-group differences were found for the outcome of all-cause mortality or for a composite renal outcome comprising the fi rst occurrence of long-term dialysis, renal transplantation, or a sustained reduction in eGFR.”
What the sources say
- Not checked yetcites [202] Bhatt, 2021, Sotagliflozin in patients with diabetes and chronic kidney disease, N Engl J Med source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“In general, the adverse effects of sotagli fl ozin were similar to those seen with use of SGLT2 inhibitors, but they also included an increased rate of diarrhea potentially related to the inhibition of SGLT1.”
What the sources say
- Not checked yetcites [202] Bhatt, 2021, Sotagliflozin in patients with diabetes and chronic kidney disease, N Engl J Med source
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“The primary outcome of cardiovascular death, MI, stroke, or hospitalization for unstable angina occurred in 406 patients (13.4%) in the lixisenatide group vs. 399 (13.2%) in the placebo group (HR 1.2 [95% CI 0.89 -1.17]), which demonstrated the noninferiority of lixisenatide to placebo ( P < 0.001) but did not show superiority ( P = 0.81).”
What the sources say
- Not checked yetcites [208] Pfeffer, 2015, Lixisenatide in patients with type 2 diabetes and acute coronary syndrome, N Engl J Med source
plainn = 406- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“An increased risk for diabetic ketoacidosis was noted, however, with 2.2 and 0.2 events per 1,000 patient-years noted in the canagli fl ozin and placebo groups, respectively (HR 10.80 [95% CI 1.39 -83.65]) (194).”
What the sources say
- Not checked yetcites [194] Perkovic, 2019, Canagliflozin and renal outcomes in type 2 diabetes and nephropathy, N Engl J Med source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Ertugli fl ozin was not superior to placebo for the key secondary outcomes of death from cardiovascular causes or hospitalization for heart failure; death from cardiovascular causes; or the composite of death from renal causes, renal replacement therapy, or doubling of the serum creatinine level.”
What the sources say
- Not checked yetcites [201] Cannon, 2020, Cardiovascular outcomes with ertugliflozin in type 2 diabetes, N Engl J Med source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“In terms of safety, no signi fi cant increase in lower-limb amputations, fractures, acute kidney injury, or hyperkalemia was noted for canaglifl ozin relative to placebo in CREDENCE.”
What the sources say
- Not checked yetcites [194] Perkovic, 2019, Canagliflozin and renal outcomes in type 2 diabetes and nephropathy, N Engl J Med source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“or hospitalization for heart failure (HR 0.71 [95% CI 0.55 -0.92]).”
What the sources say
- Not checked yetcites [197] Heerspink, 2020, Dapagliflozin in patients with chronic kidney disease, N Engl J Med source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
The quote only partly states this claim.
In the paper
“SCORED ended early due to a lack of funding; thus, changes to the prespeci fi ed primary end points were made prior to unblinding to accommodate a lower than anticipated number of end point events.”
What the sources say
- Not checked yetcites [202] Bhatt, 2021, Sotagliflozin in patients with diabetes and chronic kidney disease, N Engl J Med source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“The incidence of acute pancreatitis, pancreatic cancer, medullary thyroid carcinoma, and serious adverse events did not differ signi fi cantly between the two groups.”
What the sources say
- Not checked yetcites [209] Holman, 2017, Effects of once-weekly exenatide on cardiovascular outcomes in type 2 diabetes, N Engl J Med source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“The Exenatide Study of Cardiovascular Event Lowering (EXSCEL) trial also reported results with the once-weekly GLP-1 receptor agonist extended-release exenatide and found that major adverse cardiovascular events were numerically lower with use of extended-release exenatide compared with placebo, although this difference was not statistically signi fi cant (209).”
What the sources say
- Not checked yetcites [209] Holman, 2017, Effects of once-weekly exenatide on cardiovascular outcomes in type 2 diabetes, N Engl J Med source
plainn = 839- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Over a median follow-up of 1.8 years, efpeglenatide therapy reduced the risk of incident major adverse cardiovascular events by 27% and of a composite renal outcome event by 32%.”
What the sources say
- Not checked yetcites [214] Gerstein, 2021, Cardiovascular and renal outcomes with efpeglenatide in type 2 diabetes, N Engl J Med source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“EMPEROR-Preserved, a randomized double-blinded placebo-controlled trial of 5,988 adults with NYHA functional class I -IV chronic HFpEF (left ventricular ejection fraction > 40%), evaluated the ef fi cacy of empagli fl ozin 10 mg daily versus placebo on top of standard of care on the primary outcome of composite cardiovascular death or hospitalization for heart failure (189).”
What the sources say
- Not checked yetcites [189] Anker, 2021, Empagliflozin in heart failure with a preserved ejection fraction, N Engl J Med source
plainn = 5,988- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“In 3,730 patients with NYHA class II -IV heart failure with an ejection fraction of # 40%, treatment with empagli fl ozin reduced the combined risk of death, hospitalization for heart failure, or an emergent/urgent heart failure visit requiring intravenous treatment and reduced the total number of hospitalizations for heart failure requiring intensive care, a vasopressor or positive inotropic drug”
What the sources say
- Not checked yetcites [229] Packer, 2021, Effect of empagliflozin on the clinical stability of patients with heart failure and a reduced ejection fraction: the EMPEROR-Reduced trial, Circulation source
plaindirectn = 3,730- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
The quote only partly states this claim.
In the paper
“The fi ndings on the studied end points were consistent in both trials of heart failure with mildly reduced or preserved ejection fraction and in all fi ve trials combined.”
What the sources say
- Not checked yetcites [227] Vaduganathan, 2022, SGLT-2 inhibitors in patients with heart failure: a comprehensive meta-analysis of five randomised controlled trials, Lancet source
plainn = 21,947- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“SGLT2 inhibitors also reduce risk of heart failure hospitalization and progression of kidney disease in people with established ASCVD, multiple risk factors for ASCVD, or albuminuric kidney disease (212,213).”
What the sources say
- Not checked yetcites [212] Zelniker, 2019, SGLT2 inhibitors for primary and secondary prevention of cardiovascular and renal outcomes in type 2 diabetes: a systematic review and meta-analysis of cardiovascular outcome trials, Lancet source
- Not checked yetcites [213] McGuire, 2021, Association of SGLT2 inhibitors with cardiovascular and kidney outcomes in patients with type 2 diabetes: a meta-analysis, JAMA Cardiol source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“No signi fi cant between-group differences were found in the rates of cardiovascular death or all-cause mortality.”
What the sources say
- Not checked yetcites [228] Bhatt, 2021, Sotagliflozin in patients with diabetes and recent worsening heart failure, N Engl J Med source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Collectively, these studies indicate that SGLT2 inhibitors reduce the risk for heart failure hospitalization and cardiovascular death in a wide range of people with heart failure.”
hedgeddirectn = 21,947- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“In summary, there are now numerous large randomized controlled trials reporting statistically signi fi cant reductions in cardiovascular events for three of the FDA-approved SGLT2 inhibitors (empagli fl ozin, canagli fl ozin, dapagli fl ozin, with lesser bene fi ts seen with ertugli fl ozin)”
What the sources say
- Not checked yetcites [9] Neal, 2017, Canagliflozin and cardiovascular and renal events in type 2 diabetes, N Engl J Med source
- Not checked yetcites [194] Perkovic, 2019, Canagliflozin and renal outcomes in type 2 diabetes and nephropathy, N Engl J Med source
- Not checked yetcites [196] Wiviott, 2019, Dapagliflozin and cardiovascular outcomes in type 2 diabetes, N Engl J Med source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“However, the relatively small percentage of such patients enrolled (only 21% of participants had ejection fraction > 50%) and the early termination of the trial limited the ability to determine the effects of sotagli fl ozin in HFpEF speci fi cally.”
What the sources say
- Not checked yetcites [228] Bhatt, 2021, Sotagliflozin in patients with diabetes and recent worsening heart failure, N Engl J Med source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“At a median follow-up of 9 months, the rate of primary end point events (the total number of cardiovascular deaths and hospitalizations and urgent visits for heart failure) was lower in the sotaglifl ozin group than in the placebo group (51.0 vs. 76.3; HR 0.67 [95% CI 0.52 -0.85]; P < 0.001).”
What the sources say
- Not checked yetcites [228] Bhatt, 2021, Sotagliflozin in patients with diabetes and recent worsening heart failure, N Engl J Med source
plaindirectn = 1,222- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
The quote only partly states this claim.
In the paper
“Additional data from the CREDENCE trial with canagli fl ozin showed a 39% reduction in hospitalization for heart failure, and 31% reduction in the composite of cardiovascular death or hospitalization for heart failure, in a diabetic kidney disease population with albuminuria (UACR > 300 to 5,000 mg/g) (194).”
What the sources say
- Not checked yetcites [194] Perkovic, 2019, Canagliflozin and renal outcomes in type 2 diabetes and nephropathy, N Engl J Med source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“Similarly, in CANVAS and DECLARE-TIMI 58, there were 33% and 27% reductions in hospitalization for heart failure, respectively, with SGLT2 inhibitor use versus placebo (9,196).”
What the sources say
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“As discussed in detail in Section 11, ' Chronic Kidney Disease and Risk Management, ' people with diabetes are at an increased risk for CKD, which increases cardiovascular risk (232).”
What the sources say
- Not checked yetcites [232] Gansevoort, 2013, Chronic kidney disease and cardiovascular risk: epidemiology, mechanisms, and prevention, Lancet source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“A prespeci fi ed subgroup analysis from FIGARO-DKD further revealed that in patients without symptomatic HFrEF, fi nerenone reduces the risk for new-onset heart failure and improves heart failure outcomes in people with type 2 diabetes and CKD (187).”
What the sources say
- Not checked yetcites [187] Filippatos, 2022, Finerenone reduces risk of incident heart failure in patients with chronic kidney disease and type 2 diabetes: analyses from the FIGARO-DKD trial, Circulation source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
84 of 84
The paper relies on this without support.
Common conditions coexisting with type 2 diabetes, such as hypertension and dyslipidemia, are risk factors for ASCVD, and diabetes itself confers independent risk.
“Common conditions coexisting with type 2 diabetes (e.g., hypertension and dyslipidemia) are clear risk factors for ASCVD, and diabetes itself confers independent risk.”
The paper relies on this without support.
The majority of evidence supporting interventions to reduce cardiovascular risk in diabetes comes from trials of people with type 2 diabetes.
“Notably, the majority of evidence supporting interventions to reduce cardiovascular risk in diabetes comes from trials of people with type 2 diabetes.”
The paper relies on this without support.
No randomized trials have been specifically designed to assess the impact of cardiovascular risk reduction strategies in people with type 1 diabetes.
“No randomized trials have been speci fi cally designed to assess the impact of cardiovascular risk reduction strategies in people with type 1 diabetes.”
The paper relies on this without support.
Hypertension is common among people with either type 1 or type 2 diabetes.
“Hypertension is common among people with either type 1 or type 2 diabetes.”
The paper relies on this without support.
Hypertension is a major risk factor for both ASCVD and microvascular complications.
“Hypertension is a major risk factor for both ASCVD and microvascular complications.”
The paper relies on this without support.
In the absence of albuminuria, the risk of progressive kidney disease is low.
“In the absence of albuminuria, risk of progressive kidney disease is low, and ACE inhibitors and ARBs have not been found to afford superior cardioprotection when compared with thiazide-like diuretics or dihydropyridine calcium channel blockers (68).”
The paper relies on this without support.
Multiple-drug therapy is often required to achieve blood pressure targets, particularly in diabetic kidney disease.
“Multiple-drug therapy is often required to achieve blood pressure targets ( Fig. 10.2 ), particularly in the setting of diabetic kidney disease.”
The paper relies on this without support.
Adding a mineralocorticoid receptor antagonist to a regimen including an ACE inhibitor or ARB may increase the risk for hyperkalemia.
“However, adding a mineralocorticoid receptor antagonist to a regimen including an ACE inhibitor or ARB may increase the risk for hyperkalemia, emphasizing the importance of regular monitoring for serum creatinine and potassium in these patients, and long-term outcome studies are needed to better evaluate the role of mineralocorticoid receptor antagonists in blood pressure management.”
The paper relies on this without support.
Glycemic control may beneficially modify plasma lipid levels, particularly in patients with very high triglycerides and poor glycemic control.
“Glycemic control may also bene fi cially modify plasma lipid levels, particularly in patients with very high triglycerides and poor glycemic control.”
The paper relies on this without support.
People with type 2 diabetes have an increased prevalence of lipid abnormalities, contributing to their high risk of ASCVD.
“People with type 2 diabetes have an increased prevalence of lipid abnormalities, contributing to their high risk of ASCVD.”
The paper relies on this without support.
Cardiovascular risk is enhanced in people with diabetes.
“Since cardiovascular risk is enhanced in people with diabetes, as noted above, patients who also have multiple other coronary risk factors have increased risk, equivalent to that of those with ASCVD.”
The paper relies on this without support.
Patients with diabetes and multiple other coronary risk factors have increased risk equivalent to that of those with ASCVD.
“Since cardiovascular risk is enhanced in people with diabetes, as noted above, patients who also have multiple other coronary risk factors have increased risk, equivalent to that of those with ASCVD.”
The paper relies on this without support.
Patients under 40 years of age have lower 10-year cardiovascular risk but high lifetime risk of cardiovascular disease and events.
“Patients < 40 years of age have lower risk of developing a cardiovascular event over a 10-year horizon; however, their lifetime risk of developing cardiovascular disease and suffering an MI, stroke, or cardiovascular death is high.”
The paper relies on this without support.
Aspirin is associated with Reye syndrome in people younger than 21 years, which makes its use generally contraindicated in that age group.
“Aspirin use in patients aged < 21 years is generally contraindicated due to the associated risk of Reye syndrome.”
The paper relies on this without support.
Platelet function is altered in people with diabetes.
“Although platelets from people with diabetes have altered function, it is unclear what, if any, effect that fi nding has on the required dose of aspirin for cardioprotective effects in people with diabetes.”
The paper relies on this without support.
In clinical trials of people with diabetes, average daily aspirin doses ranged from 50 to 650 mg, mostly 100-325 mg/day.
“Average daily dosages used in most clinical trials involving people with diabetes ranged from 50 mg to 650 mg but were mostly in the range of 100 -325 mg/day.”
The paper relies on this without support.
No randomized trial of metformin therapy has been conducted in people with heart failure.
“however, no randomized trial of metformin therapy has been conducted in people with heart failure.”
The paper relies on this without support.
Most patients enrolled in the relevant trials were receiving metformin at baseline as glucose-lowering therapy.
“' Most patients enrolled in the relevant trials were on metformin at baseline as glucose-lowering therapy.”
The authors state this as an assumption.
Peripheral artery disease is assumed to be atherosclerotic in origin.
“*ASCVD is defined as a history of an acute coronary syndrome or MI, stable or unstable angina, coronary heart disease with or without revascularization, other arterial revascularization, stroke, or peripheral artery disease assumed to be atherosclerotic in origin.”
19 of 19
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
The source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“and current guidelines recommend the use of GLP-1 receptor agonists in patients with diabetes who need cardiovascular risk reduction, weight management, or both. 38,39”
From Semaglutide and Cardiovascular Outcomes in Obesity without Diabetes (2023) · cites this paper as [38]
Experimental — accuracy not yet measured
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
Each contradiction between two passages listed here was confirmed by an independent check.
Rated minor: it would not touch a result — a value no result rests on, a p-value that stays on the same side of the significance level, or a conflict that is clerical, resolved elsewhere in the paper, or outside its own findings.
In the paper
§ Randomized Controlled Trials of Intensive Versus Standard Blood Pressure Control · p. 4
“The mean achieved systolic blood pressures were 119 mmHg and 133 mmHg in the intensive versus standard group, respectively.”
§ Individualization of Treatment Targets · p. 5
“Achieved (mean) SBP/DBP: 135/70.5 mmHg”
Rated minor: it would not touch a result — a value no result rests on, a p-value that stays on the same side of the significance level, or a conflict that is clerical, resolved elsewhere in the paper, or outside its own findings.
In the paper
§ GLP-1 Receptor Agonist Trials · p. 24
“in 9,990 people with type 2 diabetes”
§ Recommendations · p. 17
“REWIND (207) ( n = 9,901)”
Rated minor: it would not touch a result — a value no result rests on, a p-value that stays on the same side of the significance level, or a conflict that is clerical, resolved elsewhere in the paper, or outside its own findings.
In the paper
§ GLP-1 Receptor Agonist Trials · p. 24
“HR 1.2”
§ GLP-1 Receptor Agonist Trials · p. 24
“95% CI 0.89 -1.17”
3 of 3
Citations
Cites
Empagliflozin, Cardiovascular Outcomes, and Mortality in Type 2 Diabetes
Zinman, B., Wanner, C., Lachin, J. M., Fitchett, D., Bluhmki, E., Hantel, S., Mattheus, M., Devins, T., Johansen, O. E., Woerle, H. J., et al. (2015) · New England Journal of Medicine · doi:10.1056/nejmoa1504720 · Cited by 12,315
Ahmed, A., Jorna, T., & Bhandari, S. (2016) · The Nephron journals/Nephron journals · doi:10.1159/000447068 · Cited by 11,782
Zhang, Q., Wang, C., Zheng, M., Li, Y., Li, J., Zhang, L., Shang, X., & Yan, C. (2014) · Cerebrovascular Diseases · doi:10.1159/000369778 · Cited by 11,609
2018 ESC/ESH Guidelines for the management of arterial hypertension
Williams, B., Mancia, G., Spiering, W., Agabiti Rosei, E., Azizi, M., Burnier, M., Clement, D. L., Coca, A., de Simone, G., Dominiczak, A., et al. (2018) · European Heart Journal · doi:10.1093/eurheartj/ehy339 · Cited by 10,286
Mach, F., Baigent, C., Catapano, A. L., Koskinas, K. C., Casula, M., Badimon, L., Chapman, M. J., De Backer, G. G., Delgado, V., Ference, B. A., et al. (2020) · European Heart Journal · doi:10.1093/eurheartj/ehz455 · Cited by 8,961
European Guidelines on cardiovascular disease prevention in clinical practice (version 2012)
Authors/Task Force Members:, Perk, J., De Backer, G., Gohlke, H., Graham, I., Reiner, Ž., Verschuren, M., Albus, C., Benlian, P., Boysen, G., et al. (2012) · European Heart Journal · doi:10.1093/eurheartj/ehs092 · Cited by 8,490
James, P. A., Oparil, S., Carter, B. L., Cushman, W. C., Dennison-Himmelfarb, C., Handler, J., Lackland, D. T., LeFevre, M. L., MacKenzie, T. D., Ogedegbe, O., et al. (2014) · JAMA · doi:10.1001/jama.2013.284427 · Cited by 7,950
Canagliflozin and Cardiovascular and Renal Events in Type 2 Diabetes
Neal, B., Perkovic, V., Mahaffey, K. W., de Zeeuw, D., Fulcher, G., Erondu, N., Shaw, W., Law, G., Desai, M., & Matthews, D. R. (2017) · New England Journal of Medicine · doi:10.1056/nejmoa1611925 · Cited by 7,830
Liraglutide and Cardiovascular Outcomes in Type 2 Diabetes
Marso, S. P., Daniels, G. H., Brown-Frandsen, K., Kristensen, P., Mann, J. F. E., Nauck, M. A., Nissen, S. E., Pocock, S., Poulter, N. R., Ravn, L. S., et al. (2016) · New England Journal of Medicine · doi:10.1056/nejmoa1603827 · Cited by 7,629
Dapagliflozin in Patients with Heart Failure and Reduced Ejection Fraction
McMurray, J. J. V., Solomon, S. D., Inzucchi, S. E., Køber, L., Kosiborod, M. N., Martinez, F. A., Ponikowski, P., Sabatine, M. S., Anand, I. S., Bělohlávek, J., et al. (2019) · New England Journal of Medicine · doi:10.1056/nejmoa1911303 · Cited by 7,140
Self-citation
Cited by
Sorted by citations
Semaglutide and Cardiovascular Outcomes in Obesity without Diabetes
Lincoff, A. M., Brown-Frandsen, K., Colhoun, H. M., Deanfield, J., Emerson, S. S., Esbjerg, S., Hardt-Lindberg, S., Hovingh, G. K., Kahn, S. E., Kushner, R. F., et al. (2023) · New England Journal of Medicine · doi:10.1056/nejmoa2307563 · Cited by 3,236
“38,39 Major adverse cardiovascular events were reduced by approximately 14% in a meta-analysis of GLP-1 receptor agonists (hazard ratio, 0.86; 95% CI, 0.80 to 0.93) among patients with type 2 diabetes and preexisting cardiovascular disease or cardiovascular risk factors, 10 with similar benefits…”
InfluentialMartin, S. S., Aday, A. W., Almarzooq, Z. I., Anderson, C. A. M., Arora, P., Avery, C. L., Baker-Smith, C. M., Barone Gibbs, B., Beaton, A. Z., Boehme, A. K., et al. (2024) · Circulation · doi:10.1161/cir.0000000000001209 · Cited by 2,800
Cardiovascular-kidney-metabolic health: a presidential advisory from the American Heart Association
Ndumele, C. E., Rangaswami, J., Chow, S. L., Neeland, I. J., Tuttle, K. R., Khan, S. S., Coresh, J., Mathew, R. O., Baker-Smith, C. M., Carnethon, M. R., et al. (2023) · Circulation · doi:10.1161/cir.0000000000001184 · Cited by 2,208
“…from the American Diabetes Association suggests that diagnostic testing for subclinical HF should likely be based on age and comorbidity profile, 68 but the optimal strategy for identifying subclinical HF in the population, reflecting both clinical benefit and cost-effectiveness, is still being…”
BackgroundInfluentialSelf-citationNdumele, C. E., Neeland, I. J., Tuttle, K. R., Chow, S. L., Mathew, R. O., Khan, S. S., Coresh, J., Baker-Smith, C. M., Carnethon, M. R., Després, J.-P., et al. (2023) · Circulation · doi:10.1161/cir.0000000000001186 · Cited by 1,405
“62,63,69,76,77 Obesity confers greater risk with longer severity and duration, supporting the concept of addressing excess weight at early points in the life course.”
BackgroundSelf-citationMartin, S. S., Aday, A. W., Allen, N. B., Almarzooq, Z., Anderson, C. A. M., Arora, P. K., Avery, C. L., Baker-Smith, C. M., Bansal, N., Beaton, A., et al. (2025) · Circulation · doi:10.1161/cir.0000000000001303 · Cited by 1,284
Metadata
- Authors
- ElSayed, N. A., Aleppo, G., Aroda, V. R., Bannuru, R. R., Brown, F. M., Bruemmer, D., Collins, B. S., Das, S. R., Hilliard, M. E., Isaacs, D., Johnson, E. L., Kahan, S., Khunti, K., Kosiborod, M., Leon, J., Lyons, S. K., Perry, M. L., Prahalad, P., Pratley, R. E., Seley, J. J., Stanton, R. C., & Gabbay, R. A.
- ORCID
- ElSayed, Nuha A.
- Aleppo, Grazia
- Aroda, Vanita R.
- Bannuru, Raveendhara R.
- Brown, Florence M.
- Bruemmer, Dennis
- Collins, Billy S.
- Das, Sandeep R.
- Hilliard, Marisa E.
- Isaacs, Diana
- Johnson, Eric L.
- Kahan, Scott
- Khunti, Kamlesh
- Kosiborod, Mikhail
- Lyons, Sarah K.
- Perry, Mary Lou
- Prahalad, Priya
- Pratley, Richard E.
- Seley, Jane Jeffrie
- Stanton, Robert C.
- Gabbay, Robert A.
- Venue
- Diabetes Care
- Publisher
- American Diabetes Association
- Published
- 2022-12-12
- Volume
- 46
- Issue
- Supplement_1
- Pages
- S158-S190
- ISSN
- 0149-5992 (ISSN-L)
- PMC
- PMC9810475
- OpenAlex
- W4311263985
- Cited by
- 465
- References
- 265
- Citations by year
- 2026: 43 · 2025: 104 · 2024: 186 · 2023: 132
- FWCI
- 15.01
- Type
- journal article
- Language
- en
- Update notices
- correction (2023-01-26)
- Open access
- bronze
- doi.org
- Locations
- Diabetes Care (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Keywords
- cardiovascular disease, diabetes mellitus, cardiovascular risk management, clinical guidelines, quality of care, treatment goals
- MeSH terms
- Cardiovascular Diseases, Diabetes Mellitus, Endocrinology, Humans, Reference Standards, Societies, Medical, Standard of Care
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
A language model drew the claims from the paper on 2026-10-05, under version 3 of the claim definition (model deepseek-v4.1-flash, prompt extract-v3).
A second model labelled each claim on 2026-10-05 (model jev-1.13-20260917, definition revision gold-guideline-v0.2).
Cited sources are checked with a language model’s help (gpt-6-sol).
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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