TY - JOUR
T1 - 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
AU - González-Juanatey, Carlos
AU - Anguita-Sánchez, Manuel
AU - Barrios, Vivencio
AU - Núñez-Gil, Iván
AU - Gómez-Doblas, Juan José
AU - Garcia-Moll, Xavier
AU - Lafuente-Gormaz, Carlos
AU - Rollán-Gómez, María Jesús
AU - Peral-Disdier, Vicente
AU - Martinez-Dolz, Luis
AU - Rodríguez-Santamarta, Miguel
AU - Viñolas, Xavier
AU - Soriano-Colomé, Toni
AU - Muñoz-Aguilera, Roberto
AU - Plaza, Ignacio
AU - Curcio-Ruigómez, Alejandro
AU - Orts-Soler, Ernesto
AU - Segovia-Cubero, Javier
AU - Fanjul, Víctor
AU - Marin-Corral, Judith
AU - Cequier, Ángel
PY - 2023
Y1 - 2023
N2 - 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.
AB - 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.
KW - MACE
KW - Aging
KW - Coronary artery disease
KW - Electronic health records
KW - Natural language processing
KW - Real-world data
KW - Type 2 diabetes mellitus
U2 - 10.3390/jcm12165218
DO - 10.3390/jcm12165218
M3 - Article
C2 - 37629262
SN - 2077-0383
VL - 12
JO - Journal of Clinical Medicine
JF - Journal of Clinical Medicine
IS - 16
ER -