Major Adverse Cardiovascular Events in Coronary Type 2 Diabetic Patients : Identification of Associated Factors Using Electronic Health Records and Natural Language Processing
González-Juanatey, Carlos (Hospital Universitario Lucus Augusti (Lugo))
Anguita-Sánchez, Manuel (Instituto Maimónides de Investigación Biomédica de Córdoba)
Barrios, Vivencio (Hospital Universitario Ramón y Cajal (Madrid))
Núñez-Gil, Iván (Hospital Clínico San Carlos (Madrid))
Gómez-Doblas, Juan José (Hospital Universitario Virgen de la Victoria. Centro de Investigación Biomédica en Red Enfermedades Cardiovasculares. Instituto de Investigación Biomédica de Málaga)
Garcia-Moll, Xavier (Institut d'Investigació Biomèdica Sant Pau)
Lafuente-Gormaz, Carlos (Complejo Hospitalario Universitario de Albacete)
Rollán-Gómez, María Jesús (Hospital Universitario Río Hortega (Valladolid))
Peral-Disdier, Vicente (Hospital Universitari Son Espases (Palma de Mallorca, Balears))
Martínez-Dolz, Luis (Hospital Universitario y Politécnico La Fe. Centro de Investigación Biomédica en Red Enfermedades Cardiovasculares. Instituto de Investigación Sanitaria La Fe de Valencia)
Rodríguez-Santamarta, Miguel (Hospital Universitario de León)
Viñolas, Xavier (Institut d'Investigació Biomèdica Sant Pau)
Soriano-Colomé, Toni (Hospital Universitari Vall d'Hebron)
Muñoz-Aguilera, Roberto (Hospital Universitario Infanta Leonor)
Plaza, Ignacio (Hospital Universitario Infanta Sofía (San Sebastián de los Reyes))
Curcio, Alejandro (Hospital Universitario de Fuenlabrada ( Madrid))
Orts-Soler, Ernesto (Consorci Hospitalari Provincial de Castelló)
Segovia, Javier (Hospital Universitario Puerta de Hierro Majadahonda (Madrid))
Fanjul, Víctor (Savana Research)
Cequier, Ángel (Institut d'Investigació Biomèdica de Bellvitge)

Fecha:	2022
Resumen:	Patients with Type 2 diabetes mellitus (T2DM) and coronary artery disease (CAD) are at high risk of developing major adverse cardiovascular events (MACE). This is a multicenter, retrospective, and observational study performed in Spain aimed to characterize these patients in a real-world setting. Unstructured data from the Electronic Health Records were extracted by EHRead, a technology based on Natural Language Processing and machine learning. The association between new MACE and the variables of interest were investigated by univariable and multivariable analyses. From a source population of 2,184,662 patients, we identified 4072 adults diagnosed with T2DM and CAD (62. 2% male, mean age 70 ± 11). The main comorbidities observed included arterial hypertension, hyperlipidemia, and obesity, with metformin and statins being the treatments most frequently prescribed. MACE development was associated with multivessel (Hazard Ratio (HR) = 2. 49) and single coronary vessel disease (HR = 1. 71), transient ischemic attack (HR = 2. 01), heart failure (HR = 1. 32), insulin treatment (HR = 1. 40), and percutaneous coronary intervention (PCI) (HR = 2. 27), whilst statins (HR = 0. 73) were associated with a lower risk of MACE occurrence. In conclusion, we found six risk factors associated with the development of MACE which were related with cardiovascular diseases and T2DM severity, and treatment with statins was identified as a protective factor for new MACE in this study.
Nota:	Altres ajuts: AstraZeneca Spain (Externally Sponsored Scientific Research, ESR-18-13815); Sociedad Española de Cardiología.
Derechos:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Lengua:	Anglès
Documento:	Article ; recerca ; Versió publicada
Materia:	Diabetes mellitus ; Coronary artery disease ; MACE ; Risk factors ; Electronic health records ; Natural language processing
Publicado en:	Journal of clinical medicine, Vol. 11 Núm. 20 (october 2022) , p. 6004, ISSN 2077-0383

DOI: 10.3390/jcm11206004
PMID: 36294325

12 p, 1.2 MB

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