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
González-Juanatey, Carlos (Hospital Universitario Lucus Augusti (Lugo))
Anguita, Manuel (Universidad de Córdoba)
Barrios, Vivencio (Hospital Universitario Ramón y Cajal (Madrid))
Nuñez-Gil, Ivan Javier (Universidad Europea de Madrid)
Gómez-Doblas, Juan José (Hospital Universitario Virgen de la Victoria (Màlaga, Andalusia))
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))
Martinez-Dolz, Luis (Hospital Universitari i Politècnic La Fe (València))
Rodríguez-Santamarta, Miguel (Hospital Universitario de León)
Viñolas, Xavier (Institut d'Investigació Biomèdica Sant Pau)
Soriano-Colomé, Toni (Hospital Universitari Vall d'Hebron. Institut de Recerca)
Muñoz-Aguilera, Roberto (Hospital Universitario Infanta Leonor)
Plaza, Ignacio (Hospital Universitario Infanta Sofía)
Curcio, Alejandro (Hospital Universitario de Fuenlabrada ( Madrid))
Orts-Soler, Ernesto (Hospital General Universitario de Castellón)
Segovia-Cubero, Javier (Hospital Universitario Puerta de Hierro Majadahonda (Madrid))
Fanjul, Víctor (Savana Research SL)
Marin-Corral, Judith (Savana Research SL)
Cequier, Ángel (Hospital Universitari de Bellvitge)
Universitat Autònoma de Barcelona

Date:	2023
Abstract:	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.
Rights:	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.
Language:	Anglès
Document:	Article ; recerca ; Versió publicada
Subject:	MACE ; Aging ; Coronary artery disease ; Electronic health records ; Natural language processing ; Real-world data ; Type 2 diabetes mellitus
Published in:	Journal of clinical medicine, Vol. 12 Núm. 16 (august 2023) , p. 5218, ISSN 2077-0383

DOI: 10.3390/jcm12165218
PMID: 37629262

23 p, 1.5 MB

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Research literature > UAB research groups literature > Research Centres and Groups (research output) > Health sciences and biosciences > Institut de Recerca Sant Pau
Articles > Research articles
Articles > Published articles