Matthews (2021)

Myocardial infarction

Cardiology • Registry Data • Sweden

Study Metrics
Total Sample 4940
Treatment Group 2634
Control Group 2306
Covariates 21
PICO Comparisons 4
Quality Indicators
Transparency High
DAG Usage No
QBA Performed No

Study Information

First Author: Matthews
Publication Year: 2021
DOI: https://doi.org/10.1161/jaha.120.020357
Preprint: https://doi.org/10.1101/2021.02.01.21250739

Institution & Funding

Institution Type: Academic
Institutions: Karolinska Institutet, Karolinska University Hospital, Harvard T.H. Chan School of Public Health, Uppsala University, Lund University, Skåne University Hospital, Danderyd University Hospital, Harvard-MIT
Funding: Declared: Public
Funding Institutions: This work was supported by a grant from the Swedish Research Council (registration number 2018-03028).

Study Context

Disease: Myocardial infarction
Disease Category: Cardiology
Data Type: Registry
Geography: Sweden
Eligible Sample: 4940.0
Number of Treatments: 2

Analytical Methods

Missing Data Method: Complete case
Matching Method: IPTW
Analysis Method: logistic regression
Estimand: PP

Quality Methods

Directed Acyclic Graph (DAG) Not Used
Quantitative Bias Analysis (QBA) Not Performed

Target Trial Information

Target Trial Name: VALIDATE-SWEDEHEART
Registration Number: NCT02311231
Target Trial DOI: https://doi.org/10.1056/nejmoa1706443

TTE vs RCT Comparisons

Detailed comparison between Target Trial Emulation results and corresponding Randomized Controlled Trial outcomes.

Composite of death from any cause, MI, or major bleeding events by 180 days
VALIDATE
RR Efficacy
Population

patients undergoing percutaneous coronary intervention in Sweden

Intervention

bivalirudin

Comparison

heparin

Outcome

Composite of death from any cause, MI, or major bleeding events by 180 days

RCT Result

0.96

95% CI: [0.83, 1.10]


vs
TTE Result

0.93

95% CI: [0.77, 1.12]

Concordance Assessment
Confidence Interval Overlap: Yes
CIs overlap, suggesting concordance
Direction Agreement: Same Direction
Both point to similar conclusion
Death by 180 days
VALIDATE
RR Efficacy
Population

patients undergoing percutaneous coronary intervention in Sweden

Intervention

bivalirudin

Comparison

heparin

Outcome

Death by 180 days

RCT Result

1.05

95% CI: [0.78, 1.41]


vs
TTE Result

1.21

95% CI: [0.88, 1.68]

Concordance Assessment
Confidence Interval Overlap: Yes
CIs overlap, suggesting concordance
Direction Agreement: Same Direction
Both point to similar conclusion
Major bleeding by 180 days
VALIDATE
RR Efficacy
Population

patients undergoing percutaneous coronary intervention in Sweden

Intervention

bivalirudin

Comparison

heparin

Outcome

Major bleeding by 180 days

RCT Result

1.00

95% CI: [0.84, 1.19]


vs
TTE Result

0.69

95% CI: [0.50, 0.95]

Concordance Assessment
Confidence Interval Overlap: Yes
CIs overlap, suggesting concordance
Direction Agreement: Different Direction
Different conclusions
MI by 180 days
VALIDATE
RR Efficacy
Population

patients undergoing percutaneous coronary intervention in Sweden

Intervention

bivalirudin

Comparison

heparin

Outcome

MI by 180 days

RCT Result

0.84

95% CI: [0.60, 1.19]


vs
TTE Result

1.08

95% CI: [0.76, 1.54]

Concordance Assessment
Confidence Interval Overlap: Yes
CIs overlap, suggesting concordance
Direction Agreement: Different Direction
Different conclusions

Transparency Indicators

Protocol Registration Available
Data Sharing Not Available
Code Sharing Available
Overall Transparency Score:
High Transparency - This study meets good transparency standards.

Conflicts & Funding

Conflicts of Interest: Declared: Financial
COI Institutions: AstraZeneca, Cytel, ProPublica
Funding Source: Declared: Public
Funding Institutions: This work was supported by a grant from the Swedish Research Council (registration number 2018-03028).