Study Metrics
Total Sample
14091
Treatment Group
8421
Control Group
5670
PICO Comparisons
4
Quality Indicators
Transparency
High
DAG Usage
No
QBA Performed
No
Study Information
| First Author: | Szummer |
| Publication Year: | 2020 |
| DOI: | https://doi.org/10.1161/circulationaha.120.050645 |
| Preprint: | No preprint |
Institution & Funding
| Institution Type: | Academic |
| Institutions: | Karolinska Institutet, Stanford University School of Medicine, Linköping University, Lund University, Uppsala University, University of Gothenburg, Sahlgrenska University Hospital |
| Funding: | Declared: Public, professional society, NGO |
| Funding Institutions: | K.S. was supported by the Stockholm County Council (clinical research appointment), by the Swedish Medical Association (Svenska Läkarsällskapet), and by the Swedish Heart Association (Svenska Hjärtförbundet). R.H. was supported by the Stockholm County Council (clinical postdoctoral appointment) and by the Swedish Heart and Lung Foundation. SWEDEHEART is supported by the Swedish Heart and Lung Foundation. |
Study Context
| Disease: | Acture coronary syndrome |
| Disease Category: | Cardiology |
| Data Type: | Registry |
| Number of Data Sources: | 1 |
| Geography: | Sweden |
| Eligible Sample: | 14005.0 |
| Number of Treatments: | 2 |
Analytical Methods
| Missing Data Method: | Multiple imputation |
| Matching Method: | PS matching |
| Analysis Method: | Cox PH |
| Estimand: | ITT |
Quality Methods
Directed Acyclic Graph (DAG)
Not Used
Quantitative Bias Analysis (QBA)
Not Performed
Target Trial Information
| Target Trial Name: | PLATO |
| Registration Number: | NCT00391872 |
| Target Trial DOI: | https://doi.org/10.1056/nejmoa0904327 |
TTE vs RCT Comparisons
Detailed comparison between Target Trial Emulation results and corresponding Randomized Controlled Trial outcomes.
CV Death, MI, Stroke
PLATO
HR
Efficacy
Population
patients ≥80 years of age and alive at discharge who had a MI registered for the first time in SWEDEHEART
Intervention
Clopidogrel
Comparison
Ticagrelor
Outcome
CV Death, MI, Stroke
RCT Result
0.89
95% CI: [0.74, 1.08]
vs
TTE Result
0.97
95% CI: [0.88, 1.06]
Concordance Assessment
Confidence Interval Overlap:
Yes
CIs overlap, suggesting concordance
CIs overlap, suggesting concordance
Direction Agreement:
Same Direction
Both point to similar conclusion
Both point to similar conclusion
Myocardial infarction
PLATO
HR
Efficacy
Population
patients ≥80 years of age and alive at discharge who had a MI registered for the first time in SWEDEHEART
Intervention
Clopidogrel
Comparison
Ticagrelor
Outcome
Myocardial infarction
RCT Result
0.96
95% CI: [0.74, 1.25]
vs
TTE Result
0.80
95% CI: [0.70, 0.92]
Concordance Assessment
Confidence Interval Overlap:
Yes
CIs overlap, suggesting concordance
CIs overlap, suggesting concordance
Direction Agreement:
Same Direction
Both point to similar conclusion
Both point to similar conclusion
(readmission for) major bleeding
PLATO
HR
Efficacy
Population
patients ≥80 years of age and alive at discharge who had a MI registered for the first time in SWEDEHEART
Intervention
Clopidogrel
Comparison
Ticagrelor
Outcome
(readmission for) major bleeding
RCT Result
1.02
95% CI: [0.82, 1.27]
vs
TTE Result
1.48
95% CI: [1.25, 1.76]
Concordance Assessment
Confidence Interval Overlap:
Yes
CIs overlap, suggesting concordance
CIs overlap, suggesting concordance
Direction Agreement:
Same Direction
Both point to similar conclusion
Both point to similar conclusion
Stroke
PLATO
HR
Efficacy
Population
patients ≥80 years of age and alive at discharge who had a MI registered for the first time in SWEDEHEART
Intervention
Clopidogrel
Comparison
Ticagrelor
Outcome
Stroke
RCT Result
1.58
95% CI: [0.93, 2.70]
vs
TTE Result
0.72
95% CI: [0.56, 0.93]
Concordance Assessment
Confidence Interval Overlap:
Yes
CIs overlap, suggesting concordance
CIs overlap, suggesting concordance
Direction Agreement:
Different Direction
Different conclusions
Different conclusions
Transparency Indicators
Protocol Registration
Available
Data Sharing
Not Available
Code Sharing
Not Available
Overall Transparency Score:
High Transparency - This study meets good transparency standards.
Conflicts & Funding
| Conflicts of Interest: | Declared: Financial |
| COI Institutions: | AstraZeneca, Sanofi-Aventis, BMS, Eli-Lilly, MSD, Boeringer-Ingelheim, Novartis, Bayer, Merck |
| Funding Source: | Declared: Public, professional society, NGO |
| Funding Institutions: | K.S. was supported by the Stockholm County Council (clinical research appointment), by the Swedish Medical Association (Svenska Läkarsällskapet), and by the Swedish Heart Association (Svenska Hjärtförbundet). R.H. was supported by the Stockholm County Council (clinical postdoctoral appointment) and by the Swedish Heart and Lung Foundation. SWEDEHEART is supported by the Swedish Heart and Lung Foundation. |