Impacto de la revascularización coronaria percutánea de lesiones coronarias graves en ramas secundarias

Cano-García, Macarena; Millán-Gómez, Mercedes; Sánchez-González, Carlos; Alonso‐Briales, Juan H.; Muñoz-Jiménez, Luz D.; Carrasco-Chinchilla, Fernando; Domínguez-Franco, Antonio J.; Muñoz-García, Antonio J.; Bullones-Ramírez, Juan A.; Álvarez-Rubiera, Jesús M.; Mora-Martín, Manuel de; Teresa–Galván, Eduardo de; Hernández-García, José M.; Urbano-Carrillo, Cristóbal A.

doi:10.1016/j.recesp.2018.04.017

Cited by 4 publications

(1 citation statement)

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“…In our study, we found that the risk of MACE in T2D-THEMIS-like patients according to the multivariate model was associated with the extent and severity of atherothrombosis (MVD) and with other risk factors such as history of heart valve disease and respiratory disorders (COPD/asthma). These risk factors have previously been shown to affect outcomes in general population and diabetic patients at high risk for ischemic events, specifically in patients with T2D and CAD with no history of MI or stroke and previous PCI revascularization [ 40 – 43 ]. Finally, the multivariate approach also revealed that such treatments as clopidogrel and statins were associated to a lower risk for MACE after adjusting for other factors in this clinical population; further research is warranted to confirm these findings in future studies.…”

Section: Discussionmentioning

confidence: 99%

Assessment of medical management in Coronary Type 2 Diabetic patients with previous percutaneous coronary intervention in Spain: A retrospective analysis of electronic health records using Natural Language Processing

et al. 2022

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Introduction and objectives Patients with type 2 diabetes (T2D) and stable coronary artery disease (CAD) previously revascularized with percutaneous coronary intervention (PCI) are at high risk of recurrent ischemic events. We aimed to provide real-world insights into the clinical characteristics and management of this clinical population, excluding patients with a history of myocardial infarction (MI) or stroke, using Natural Language Processing (NLP) technology. Methods This is a multicenter, retrospective study based on the secondary use of 2014–2018 real-world data captured in the Electronic Health Records (EHRs) of 1,579 patients (0.72% of the T2D population analyzed; n = 217,632 patients) from 12 representative hospitals in Spain. To access the unstructured clinical information in EHRs, we used the EHRead® technology, based on NLP and machine learning. Major adverse cardiovascular events (MACE) were considered: MI, ischemic stroke, urgent coronary revascularization, and hospitalization due to unstable angina. The association between MACE rates and the variables included in this study was evaluated following univariate and multivariate approaches. Results Most patients were male (72.13%), with a mean age of 70.5±10 years. Regarding T2D, most patients were non-insulin-dependent T2D (61.75%) with high prevalence of comorbidities. The median (Q1-Q3) duration of follow-up was 1.2 (0.3–4.5) years. Overall, 35.66% of patients suffered from at least one MACE during follow up. Using a Cox Proportional Hazards regression model analysis, several independent factors were associated with MACE during follow up: CAD duration (p < 0.001), COPD/Asthma (p = 0.021), heart valve disease (p = 0.031), multivessel disease (p = 0.005), insulin treatment (p < 0.001), statins treatment (p < 0.001), and clopidogrel treatment (p = 0.039). Conclusions Our results showed high rates of MACE in a large real-world series of PCI-revascularized patients with T2D and CAD with no history of MI or stroke. These data represent a potential opportunity to improve the clinical management of these patients.

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Section: Discussionmentioning

confidence: 99%