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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Authors: González Juanatey, Carlos, Anguita-Sánchez, M., Barrios, V., Núñez-Gil, I., Gómez-Doblas, J.J., García-Moll, X., Lafuente-Gormaz, C., Rollán-Gómez, M.J., Peral-Disdier, V., Martínez-Dolz, L., Rodríguez-Santamarta, M., Viñolas-Prat, X., Soriano-Colomé, T., Muñoz-Aguilera, R., Plaza, I., Curcio-Ruigómez, A., Orts-Soler, E., Segovia-Cubero, J., Fanjul, V., Marín-Corral, J., Cequier, Á.
Format: article
Publication Date:2023
Country:España
Institution:Servizo Galego de Saúde (SERGAS)
Repository:RUNA. Repositorio da Consellería de Sanidade e Sergas
OAI Identifier:oai:runa.sergas.gal:20.500.11940/21603
Online Access:https://portalcientifico.sergas.gal//documentos/64fffbb8ab53484a60023787
http://hdl.handle.net/20.500.11940/21603
Access Level:Open access
Keyword:AS Lugo
CHULA
Description
Summary: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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