c82e8887fbc921ab2551ace832756928 303901.pdf bb84740b722a16452f8c52bc0cf60f867f5a0dc1 303901.pdf 74c8531ac533e4dc2fad9d60476dda0b789be2269ebd006d11318dfe8102898b 303901.pdf Title: Impact of Advanced Age on the Incidence of Major Adverse Cardiovascular Events in Patients with Type 2 Diabetes Mellitus and Stable Coronary Artery Disease in a Real-World Setting in Spain Subject: Patients with type 2 diabetes mellitus (T2DM) and coronary artery disease (CAD) without myocardial infarction (MI) or stroke are at high risk for major cardiovascular events (MACEs). We aimed to provide real-world data on age-related clinical characteristics, treatment management, and incidence of major cardiovascular outcomes in T2DM-CAD patients in Spain from 2014 to 2018. We used EHRead® technology, which is based on natural language processing and machine learning, to extract unstructured clinical information from electronic health records (EHRs) from 12 hospitals. Of the 4072 included patients, 30.9% were younger than 65 years (66.3% male), 34.2% were aged 65–75 years (66.4% male), and 34.8% were older than 75 years (54.3% male). These older patients were more likely to have hypertension (OR 2.85), angina (OR 1.64), heart valve disease (OR 2.13), or peripheral vascular disease (OR 2.38) than those aged <65 years (p < 0.001 for all comparisons). In general, they were also more likely to receive pharmacological and interventional treatments. Moreover, these patients had a significantly higher risk of MACEs (HR 1.29; p = 0.003) and ischemic stroke (HR 2.39; p < 0.001). In summary, patients with T2DM-CAD in routine clinical practice tend to be older, have more comorbidities, are more heavily treated, and have a higher risk of developing MACE than is commonly assumed from clinical trial data. Keywords: type 2 diabetes mellitus; coronary artery disease; MACE; real-world data; electronic health records; natural language processing; aging Author: Carlos González-Juanatey, Manuel Anguita-Sánchez, Vivencio Barrios, Iván Núñez-Gil, Juan José Gómez-Doblas, Xavier García-Moll, Carlos Lafuente-Gormaz, María Jesús Rollán-Gómez, Vicente Peral-Disdier, Luis Martínez-Dolz, Miguel Rodríguez-Santamarta, Xavier Viñolas-Prat, Toni Soriano-Colomé, Roberto Muñoz-Aguilera, Ignacio Plaza, Alejandro Curcio-Ruigómez, Ernesto Orts-Soler, Javier Segovia-Cubero, Víctor Fanjul, Judith Marín-Corral, Ángel Cequier and SAVANA Research Group Creator: LaTeX with hyperref Producer: pdfTeX-1.40.21 CreationDate: Thu Aug 10 17:19:11 2023 CEST ModDate: Thu Aug 10 17:27:30 2023 CEST Custom Metadata: no Metadata Stream: no Tagged: no UserProperties: no Suspects: no Form: none JavaScript: no Pages: 23 Encrypted: no Page size: 595.276 x 841.89 pts (A4) Page rot: 0 File size: 1611220 bytes Optimized: no PDF 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(Rel. 1.28.0, 2023-05-18) Date: 2024-12-18 02:51:00 CET RepresentationInformation: 303901.pdf ReportingModule: PDF-hul, Rel. 1.12.4 (2023-03-16) LastModified: 2024-12-17 08:31:10 CET Size: 1611220 Format: PDF Version: 1.7 Status: Well-Formed and valid SignatureMatches: PDF-hul MIMEtype: application/pdf PDFMetadata: Objects: 481 FreeObjects: 1 IncrementalUpdates: 0 DocumentCatalog: PageLayout: SinglePage PageMode: UseNone Outlines: Item: Title: Introduction Destination: section.1 Item: Title: Materials and Methods Destination: section.2 Children: Item: Title: Study Design Destination: subsection.2.1 Item: Title: Data Source Destination: subsection.2.2 Item: Title: Study Population Destination: subsection.2.3 Item: Title: Extraction of Clinical Data from EHRs Destination: subsection.2.4 Item: Title: Statistical Data Analyses Destination: subsection.2.5 Item: Title: Ethical Considerations and Study Approval Destination: subsection.2.6 Item: Title: Results Destination: section.3 Children: Item: Title: Study Population Destination: subsection.3.1 Item: Title: Patient Demographic and Clinical Characteristics Destination: subsection.3.2 Item: Title: Pharmacological and Interventional Disease Management Destination: subsection.3.3 Item: Title: Cumulative Incidence of MACE Destination: subsection.3.4 Item: Title: Discussion Destination: section.4 Item: Title: Conclusions Destination: section.5 Item: Title: References Destination: section.6 Info: Title: Impact of Advanced Age on the Incidence of Major Adverse Cardiovascular Events in Patients with Type 2 Diabetes Mellitus and Stable Coronary Artery Disease in a Real-World Setting in Spain Author: Carlos González-Juanatey, Manuel Anguita-Sánchez, Vivencio Barrios, Iván Núñez-Gil, Juan José Gómez-Doblas, Xavier García-Moll, Carlos Lafuente-Gormaz, María Jesús Rollán-Gómez, Vicente Peral-Disdier, Luis Martínez-Dolz, Miguel Rodríguez-Santamarta, Xavier Viñolas-Prat, Toni Soriano-Colomé, Roberto Muñoz-Aguilera, Ignacio Plaza, Alejandro Curcio-Ruigómez, Ernesto Orts-Soler, Javier Segovia-Cubero, Víctor Fanjul, Judith Marín-Corral, Ángel Cequier and SAVANA Research Group Subject: Patients with type 2 diabetes mellitus (T2DM) and coronary artery disease (CAD) without myocardial infarction (MI) or stroke are at high risk for major cardiovascular events (MACEs). We aimed to provide real-world data on age-related clinical characteristics, treatment management, and incidence of major cardiovascular outcomes in T2DM-CAD patients in Spain from 2014 to 2018. We used EHRead® technology, which is based on natural language processing and machine learning, to extract unstructured clinical information from electronic health records (EHRs) from 12 hospitals. Of the 4072 included patients, 30.9% were younger than 65 years (66.3% male), 34.2% were aged 65 75 years (66.4% male), and 34.8% were older than 75 years (54.3% male). These older patients were more likely to have hypertension (OR 2.85), angina (OR 1.64), heart valve disease (OR 2.13), or peripheral vascular disease (OR 2.38) than those aged <65 years (p < 0.001 for all comparisons). In general, they were also more likely to receive pharmacological and interventional treatments. Moreover, these patients had a significantly higher risk of MACEs (HR 1.29; p = 0.003) and ischemic stroke (HR 2.39; p < 0.001). In summary, patients with T2DM-CAD in routine clinical practice tend to be older, have more comorbidities, are more heavily treated, and have a higher risk of developing MACE than is commonly assumed from clinical trial data. 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