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

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 m...

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Detalles Bibliográficos
Autores: González Juanatey, Carlos, Anguita Sánchez, Manuel, Barrios, Vivencio, Núñez Gil, Iván, Gómez Doblas, Juan José, García Moll, Xavier, Lafuente Gormaz, Carlos, Rollán Gómez, María Jesús, Peral Disdier, Vicente, Martínez Dolz, Luis, Rodríguez Santamarta, Miguel, Viñolas Prat, Xavier, Soriano Colomé, Toni, Muñoz Aguilera, Roberto, Plaza, Ignacio, Curcio Ruigómez, Alejandro, Orts Soler, Ernesto, Segovia Cubero, Javier, Fanjul, Víctor, Marín Corral, Judith, Cequier, Ángel, Savana Research Group
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2023
País:España
Institución:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
Repositorio:Recercat. Dipósit de la Recerca de Catalunya
OAI Identifier:oai:recercat.cat:2445/202131
Acceso en línea:https://hdl.handle.net/2445/202131
Access Level:acceso abierto
Palabra clave:Complicacions de la diabetis
Malalties coronàries
Persones grans
Diabetes complications
Coronary diseases
Older people
Descripción
Sumario: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 (R) 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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