Major adverse cardiovascular event definitions used in observational analysis of administrative databases: a systematic review

Elliott Bosco, Leon Hsueh, Kevin W McConeghy, Stefan Gravenstein, Elie Saade, Elliott Bosco, Leon Hsueh, Kevin W McConeghy, Stefan Gravenstein, Elie Saade

Abstract

Background: Major adverse cardiovascular events (MACE) are increasingly used as composite outcomes in randomized controlled trials (RCTs) and observational studies. However, it is unclear how observational studies most commonly define MACE in the literature when using administrative data.

Methods: We identified peer-reviewed articles published in MEDLINE and EMBASE between January 1, 2010 to October 9, 2020. Studies utilizing administrative data to assess the MACE composite outcome using International Classification of Diseases 9th or 10th Revision diagnosis codes were included. Reviews, abstracts, and studies not providing outcome code definitions were excluded. Data extracted included data source, timeframe, MACE components, code definitions, code positions, and outcome validation.

Results: A total of 920 articles were screened, 412 were retained for full-text review, and 58 were included. Only 8.6% (n = 5/58) matched the traditional three-point MACE RCT definition of acute myocardial infarction (AMI), stroke, or cardiovascular death. None matched four-point (+unstable angina) or five-point MACE (+unstable angina and heart failure). The most common MACE components were: AMI and stroke, 15.5% (n = 9/58); AMI, stroke, and all-cause death, 13.8% (n = 8/58); and AMI, stroke and cardiovascular death 8.6% (n = 5/58). Further, 67% (n = 39/58) did not validate outcomes or cite validation studies. Additionally, 70.7% (n = 41/58) did not report code positions of endpoints, 20.7% (n = 12/58) used the primary position, and 8.6% (n = 5/58) used any position.

Conclusions: Components of MACE endpoints and diagnostic codes used varied widely across observational studies. Variability in the MACE definitions used and information reported across observational studies prohibit the comparison, replication, and aggregation of findings. Studies should transparently report the administrative codes used and code positions, as well as utilize validated outcome definitions when possible.

Keywords: Acute coronary syndrome; Acute myocardial infarction; Cardiovascular disease; Heart failure; Observational study; Reproducibility; Stroke.

Conflict of interest statement

E.B., L.H., and E.S. declare no competing interests. K.W.M reports investigator-initiated grants from Seqirus, Pfizer and Sanofi Pasteur. S.G. reports grants from Seqirus, Sanofi; and consulting or speaker fees from Sanofi, Seqirus, Merck, and the Gerontological Society of America related to vaccines or nursing home care quality. The content and views expressed in this article are those of the authors and do not necessarily reflect the position or policy of the Department of Veterans Affairs or the United States government.

© 2021. The Author(s).

Figures

Fig. 1
Fig. 1
PRISMA flow diagram for included studies. Abbreviations: MACE, major adverse cardiovascular events; ICD, International Classification of Diseases

References

    1. Gal D, Thijs B, Glanzel W, Sipido KR. Hot topics and trends in cardiovascular research. Eur Heart J. 2019;40(28):2363–2374.
    1. Benjamin EJ, Muntner P, Alonso A, Bittencourt MS, Callaway CW, Carson AP, Chamberlain AM, Chang AR, Cheng S, Das SR, et al. Heart disease and stroke statistics-2019 update: a report from the American Heart Association. Circulation. 2019;139(10):e56–e528.
    1. Sharma A, Pagidipati NJ, Califf RM, McGuire DK, Green JB, Demets D, George JT, Gerstein HC, Hobbs T, Holman RR, et al. Impact of regulatory guidance on evaluating cardiovascular risk of new glucose-lowering therapies to treat type 2 diabetes mellitus: lessons learned and future directions. Circulation. 2020;141(10):843–862.
    1. Marx N, McGuire DK, Perkovic V, Woerle HJ, Broedl UC, von Eynatten M, George JT, Rosenstock J. Composite primary end points in cardiovascular outcomes trials involving type 2 diabetes patients: should unstable angina be included in the primary end point? Diabetes Care. 2017;40(9):1144–1151.
    1. Gavrielov-Yusim N, Friger M. Use of administrative medical databases in population-based research. J Epidemiol Community Health. 2014;68(3):283–287.
    1. Franklin JM, Schneeweiss S. When and how can real world data analyses substitute for randomized controlled trials? Clin Pharmacol Ther. 2017;102(6):924–933.
    1. Wang SV, Pinheiro S, Hua W, Arlett P, Uyama Y, Berlin JA, Bartels DB, Kahler KH, Bessette LG, Schneeweiss S. STaRT-RWE: structured template for planning and reporting on the implementation of real world evidence studies. BMJ (Clinical research ed) 2021;372:m4856.
    1. Franklin JM, Patorno E, Desai RJ, Glynn RJ, Martin D, Quinto K, Pawar A, Bessette LG, Lee H, Garry EM, et al. Emulating randomized clinical trials with nonrandomized real-world evidence studies: first results from the RCT DUPLICATE Initiative. Circulation. 2021;143(10):1002–1013.
    1. International Statistical Classification of Diseases and Related Health Problems (ICD). World Health Organization; 2021. . Accessed 28 Feb 2021.
    1. McCormick N, Bhole V, Lacaille D, Avina-Zubieta JA. Validity of diagnostic codes for acute stroke in administrative databases: a systematic review. PLoS One. 2015;10(8):e0135834.
    1. McCormick N, Lacaille D, Bhole V, Avina-Zubieta JA. Validity of myocardial infarction diagnoses in administrative databases: a systematic review. PLoS One. 2014;9(3):e92286.
    1. McCormick N, Lacaille D, Bhole V, Avina-Zubieta JA. Validity of heart failure diagnoses in administrative databases: a systematic review and meta-analysis. PLoS One. 2014;9(8):e104519.
    1. Moher D, Shamseer L, Clarke M, Ghersi D, Liberati A, Petticrew M, Shekelle P, Stewart LA, Group P-P Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015 statement. Syst Rev. 2015;4:1.
    1. Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, Shamseer L, Tetzlaff JM, Akl EA, Brennan SE, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ (Clinical research ed) 2021;372:n71.
    1. Wallace B, Small K, Brodley CE, Lau J, Trikalinos TA. Proceedings of the ACM International Health Informatics Symposium (IHI) 2012. Deploying an interactive machine learning system in an evidence-based practice center: abstrackr; pp. 819–824.
    1. Chapman RH, Yeaw J, Roberts CS. Association between adherence to calcium-channel blocker and statin medications and likelihood of cardiovascular events among US managed care enrollees. BMC Cardiovasc Disord. 2010;10:29.
    1. Gudbjornsson B, Thorsteinsson SB, Sigvaldason H, Einarsdottir R, Johannsson M, Zoega H, Halldorsson M, Thorgeirsson G. Rofecoxib, but not celecoxib, increases the risk of thromboembolic cardiovascular events in young adults-a nationwide registry-based study. Eur J Clin Pharmacol. 2010;66(6):619–625.
    1. Charlot M, Grove EL, Hansen PR, Olesen JB, Ahlehoff O, Selmer C, Lindhardsen J, Madsen JK, Køber L, Torp-Pedersen C, et al. Proton pump inhibitor use and risk of adverse cardiovascular events in aspirin treated patients with first time myocardial infarction: nationwide propensity score matched study. BMJ (Clinical research ed) 2011;342:d2690.
    1. Madsen M, Davidsen M, Rasmussen S, Abildstrom SZ, Osler M. The validity of the diagnosis of acute myocardial infarction in routine statistics: a comparison of mortality and hospital discharge data with the Danish MONICA registry. J Clin Epidemiol. 2003;56(2):124–130.
    1. Krarup LH, Boysen G, Janjua H, Prescott E, Truelsen T. Validity of stroke diagnoses in a National Register of Patients. Neuroepidemiology. 2007;28(3):150–154.
    1. Kociol RD, Hammill BG, Hernandez AF, Klaskala W, Mills RM, Curtis LH, Fonarow GC. Pharmacologic prophylaxis for venous thromboembolism and 30-day outcomes among older patients hospitalized with heart failure: an analysis from the ADHERE national registry linked to Medicare claims. Clin Cardiol. 2011;34(11):682–688.
    1. Chen ZY, Chiang CH, Huang CC, Chung CM, Chan WL, Huang PH, Lin SJ, Chen JW, Leu HB. The association of tooth scaling and decreased cardiovascular disease: a nationwide population-based study. Am J Med. 2012;125(6):568–575.
    1. Chen HJ, Bai CH, Yeh WT, Chiu HC, Pan WH. Influence of metabolic syndrome and general obesity on the risk of ischemic stroke. Stroke. 2006;37(4):1060–1064.
    1. Degli Esposti L, Saragoni S, Batacchi P, Benemei S, Geppetti P, Sturani A, Buda S, Degli Esposti E. Adherence to statin treatment and health outcomes in an Italian cohort of newly treated patients: results from an administrative database analysis. Clin Ther. 2012;34(1):190–199.
    1. Parker ED, Margolis KL, Trower NK, Magid DJ, Tavel HM, Shetterly SM, Ho PM, Swain BE, O'Connor PJ. Comparative effectiveness of 2 β-blockers in hypertensive patients. Arch Intern Med. 2012;172(18):1406–1412.
    1. Karthikesalingam A, Bahia SS, Patterson BO, Peach G, Vidal-Diez A, Ray KK, Sharma R, Hinchliffe RJ, Holt PJ, Thompson MM. The shortfall in long-term survival of patients with repaired thoracic or abdominal aortic aneurysms: retrospective case-control analysis of hospital episode statistics. Eur J Vasc Endovasc Surg. 2013;46(5):533–541.
    1. Mortensen EM, Halm EA, Pugh MJ, Copeland LA, Metersky M, Fine MJ, Johnson CS, Alvarez CA, Frei CR, Good C, et al. Association of azithromycin with mortality and cardiovascular events among older patients hospitalized with pneumonia. JAMA. 2014;311(21):2199–2208.
    1. Neumann A, Maura G, Weill A, Ricordeau P, Alla F, Allemand H. Comparative effectiveness of rosuvastatin versus simvastatin in primary prevention among new users: a cohort study in the French national health insurance database. Pharmacoepidemiol Drug Saf. 2014;23(3):240–250.
    1. Vanasse A, Courteau J, Asghari S, Leroux D, Cloutier L. Health inequalities associated with neighbourhood deprivation in the Quebec population with hypertension in primary prevention of cardiovascular disease. Chronic Dis Inj Can. 2014;34(4):181–194.
    1. Chou SH, Tung YC, Lin YS, Wu LS, Lin CP, Liou EJ, Chang CJ, Kung S, Chu PH. Major adverse cardiovascular events in treated periodontitis: a population-based follow-up study from Taiwan. PLoS One. 2015;10(6):e0130807.
    1. Desai JR, Vazquez-Benitez G, Xu Z, Schroeder EB, Karter AJ, Steiner JF, Nichols GA, Reynolds K, Xu S, Newton K, et al. Who must we target now to minimize future cardiovascular events and total mortality?: lessons from the surveillance, prevention and management of diabetes mellitus (SUPREME-DM) cohort study. Circ Cardiovas Qual Outcomes. 2015;8(5):508–516.
    1. Saczynski JS, Andrade SE, Harrold LR, Tjia J, Cutrona SL, Dodd KS, Goldberg RJ, Gurwitz JH. A systematic review of validated methods for identifying heart failure using administrative data. Pharmacoepidemiol Drug Saf. 2012;21(Suppl 1):129–140.
    1. Andrade SE, Harrold LR, Tjia J, Cutrona SL, Saczynski JS, Dodd KS, Goldberg RJ, Gurwitz JH. A systematic review of validated methods for identifying cerebrovascular accident or transient ischemic attack using administrative data. Pharmacoepidemiol Drug Saf. 2012;21(Suppl 1):100–128.
    1. Yeh RW, Sidney S, Chandra M, Sorel M, Selby JV, Go AS. Population trends in the incidence and outcomes of acute myocardial infarction. N Engl J Med. 2010;362(23):2155–2165.
    1. Doll JA, Hellkamp A, Thomas L, Ho PM, Kontos MC, Whooley MA, Boyden TF, Peterson ED, Wang TY. Effectiveness of cardiac rehabilitation among older patients after acute myocardial infarction. Am Heart J. 2015;170(5):855–864.
    1. Jernberg T, Hasvold P, Henriksson M, Hjelm H, Thuresson M, Janzon M. Cardiovascular risk in post-myocardial infarction patients: nationwide real world data demonstrate the importance of a long-term perspective. Eur Heart J. 2015;36(19):1163–1170.
    1. Linnersjö A, Hammar N, Gustavsson A, Reuterwall C. Recent time trends in acute myocardial infarction in Stockholm, Sweden. Int J Cardiol. 2000;76(1):17–21.
    1. Korsnes JS, Davis KL, Ariely R, Bell CF, Mitra D. Health care resource utilization and costs associated with nonfatal major adverse cardiovascular events. J Manag Care Spec Pharm. 2015;21(6):443–450.
    1. Roussel R, Chaignot C, Weill A, Travert F, Hansel B, Marre M, Ricordeau P, Alla F, Allemand H. Use of fibrates monotherapy in people with diabetes and high cardiovascular risk in primary care: a French nationwide cohort study based on national administrative databases. PLoS One. 2015;10(9):e0137733.
    1. Sirois C, Moisan J, Poirier P, Gregoire JP. Comparative effectiveness of cardioprotective drugs in elderly individuals with type 2 diabetes. Int J Clin Pract. 2015;69(3):305–312.
    1. Levy AR, Tamblyn RM, Fitchett D, McLeod PJ, Hanley JA. Coding accuracy of hospital discharge data for elderly survivors of myocardial infarction. Can J Cardiol. 1999;15(11):1277–1282.
    1. Stochkendahl MJ, Mickley H, Vach W, Aziz A, Christensen HW, Hartvigsen J, Høilund-Carlsen PF. Clinical characteristics, myocardial perfusion deficits, and clinical outcomes of patients with non-specific chest pain hospitalized for suspected acute coronary syndrome: a 4-year prospective cohort study. Int J Cardiol. 2015;182:126–131.
    1. Blin P, Philippe F, Bouee S, Laurendeau C, Torreton E, Gourmelin J, Leproust S, Levy-Bachelot L, Steg PG. Outcomes following acute hospitalised myocardial infarction in France: an insurance claims database analysis. Int J Cardiol. 2016;219:387–393.
    1. Cheng CA, Chien WC, Hsu CY, Lin HC, Chiu HW. Risk analysis of carotid stent from a population-based database in Taiwan. Medicine. 2016;95(35):e4747.
    1. Chuang CS, Ho SC, Lin CL, Lin MC, Kao CH. Risk of cerebrovascular events in pneumoconiosis patients: a population-based study, 1996-2011. Medicine. 2016;95(9):e2944.
    1. Fortuna LA, Pawloski PA, Parker ED, Trower NK, Kottke TE. Proton pump inhibitor use by aspirin-treated coronary artery disease patients is not associated with increased risk of cardiovascular events. Eur Heart J Cardiovasc Pharmacother. 2016;2(1):13–19.
    1. Kottke TE, Baechler CJ, Parker ED. Accuracy of heart disease prevalence estimated from claims data compared with an electronic health record. Prev Chronic Dis. 2012;9:E141.
    1. Hsu CY, Chen YT, Huang PH, Leu HB, Su YW, Chiang CH, Chen JW, Chen TJ, Lin SJ, Chan WL. The association between urinary calculi and increased risk of future cardiovascular events: a nationwide population-based study. J Cardiol. 2016;67(5):463–470.
    1. Lindblad U, Råstam L, Ranstam J, Peterson M. Validity of register data on acute myocardial infarction and acute stroke: the Skaraborg hypertension project. Scand J Soc Med. 1993;21(1):3–9.
    1. Cheng C-L, Kao Y-HY, Lin S-J, Lee C-H, Lai ML. Validation of the national health insurance research database with ischemic stroke cases in Taiwan. Pharmacoepidemiol Drug Saf. 2011;20(3):236–242.
    1. Shih C-J, Chen H-T, Chao P-W, Kuo S-C, Li S-Y, Yang C-Y, Tarng D-C, Ou S-M, Chen Y-T. Angiotensin-converting enzyme inhibitors, angiotensin II receptor blockers and the risk of major adverse cardiac events in patients with diabetes and prior stroke: a nationwide study. J Hypertens. 2016;34(3):567–575.
    1. Hsieh CY, Chen CH, Li CY, Lai ML. Validating the diagnosis of acute ischemic stroke in a National Health Insurance claims database. J Formos Med Assoc. 2015;114(3):254–259.
    1. Solomon DH, Liu CC, Kuo IH, Zak A, Kim SC. Effects of colchicine on risk of cardiovascular events and mortality among patients with gout: a cohort study using electronic medical records linked with Medicare claims. Ann Rheum Dis. 2016;75(9):1674–1679.
    1. Kiyota Y, Schneeweiss S, Glynn RJ, Cannuscio CC, Avorn J, Solomon DH. Accuracy of Medicare claims-based diagnosis of acute myocardial infarction: estimating positive predictive value on the basis of review of hospital records. Am Heart J. 2004;148(1):99–104.
    1. Birman-Deych E, Waterman AD, Yan Y, Nilasena DS, Radford MJ, Gage BF. Accuracy of ICD-9-CM codes for identifying cardiovascular and stroke risk factors. Med Care. 2005;43(5):480–485.
    1. Babazade R, Yilmaz HO, Leung SM, Zimmerman NM, Turan A. Systemic lupus erythematosus is associated with increased adverse postoperative renal outcomes and mortality: a historical cohort study using administrative health data. Anesth Analg. 2017;124(4):1118–1126.
    1. de Miguel-Yanes JM, Jimenez-Garcia R, Hernandez-Barrera V, Mendez-Bailon M, de Miguel-Diez J, Lopez-de-Andres A. Impact of type 2 diabetes mellitus on in-hospital-mortality after major cardiovascular events in Spain (2002-2014) Cardiovasc Diabetol. 2017;16(1):126.
    1. Lindahl B, Baron T, Erlinge D, Hadziosmanovic N, Nordenskjöld A, Gard A, Jernberg T. Medical therapy for secondary prevention and long-term outcome in patients with myocardial infarction with nonobstructive coronary artery disease. Circulation. 2017;135(16):1481–1489.
    1. Policardo L, Seghieri G, Francesconi P, Anichini R, Franconi F, Del Prato S. Gender difference in diabetes related excess risk of cardiovascular events: when does the ‘risk window’ open? J Diabetes Complicat. 2017;31(1):74–79.
    1. Tung YC, Huang YC, Wu LS, Chang CJ, Chu PH. Medication compliance and clinical outcomes of fixed-dose combinations vs free combinations of an angiotensin II receptor blocker and a calcium channel blocker in hypertension treatment. J Clin Hypertens (Greenwich) 2017;19(10):983–989.
    1. Arinze N, Farber A, Sachs T, Patts G, Kalish J, Kuhnen A, Kasotakis G, Siracuse JJ. The effect of statin use and intensity on stroke and myocardial infarction after carotid endarterectomy. J Vasc Surg. 2018;68(5):1398–1405.
    1. Baviera M, Bertele V, Avanzini F, Vannini T, Tettamanti M, Fortino I, Bortolotti A, Merlino L, Roncaglioni MC. Peripheral arterial disease: Changes in clinical outcomes and therapeutic strategies in two cohorts, from 2002 to 2008 and from 2008 to 2014. A population-based study. Eur J Prev Cardiol. 2018;25(16):1735–1743.
    1. Chan CW, Yu CL, Lin JC, Hsieh YC, Lin CC, Hung CY, Li CH, Liao YC, Lo CP, Huang JL, et al. Glitazones and alpha-glucosidase inhibitors as the second-line oral anti-diabetic agents added to metformin reduce cardiovascular risk in type 2 diabetes patients: a nationwide cohort observational study. Cardiovasc Diabetol. 2018;17(1):20.
    1. Wu VC, Chen SW, Ting PC, Chang CH, Wu M, Lin MS, Hsieh MJ, Wang CY, Chang SH, Hung KC, et al. Selection of β-blocker in patients with cirrhosis and acute myocardial infarction: a 13-year nationwide population-based study in Asia. J Am Heart Assoc. 2018;7(19):e008982.
    1. Cheng CL, Lee CH, Chen PS, Li YH, Lin SJ, Yang YH. Validation of acute myocardial infarction cases in the national health insurance research database in Taiwan. J Epidemiol. 2014;24(6):500–507.
    1. Degli Esposti L, Perrone V, Veronesi C, Buda S, Rossini R. All-cause mortality, cardiovascular events, and health care costs after 12 months of dual platelet aggregation inhibition after acute myocardial infarction in real-world patients: findings from the platelet-aggregation inhibition: persistence with treatment and cardiovascular events in real world (PIPER) study. Vasc Health Risk Manag. 2018;14:383–392.
    1. Hussain MA, Saposnik G, Raju S, Salata K, Mamdani M, Tu JV, Bhatt DL, Verma S, Al-Omran M. Association between statin use and cardiovascular events after carotid artery revascularization. J Am Heart Assoc. 2018;7(16):e009745.
    1. Juurlink D, Preyra C, Croxford R, Chong A, Austin P, Tu J, Laupacis A. Canadian institute for health information discharge abstract database: a validation study. Toronto: ICES investigative report Institute for Clinical Evaluative Sciences; 2006.
    1. Kokotailo RA, Hill MD. Coding of stroke and stroke risk factors using international classification of diseases, revisions 9 and 10. Stroke. 2005;36(8):1776–1781.
    1. Jin P, Matos Diaz I, Stein L, Thaler A, Tuhrim S, Dhamoon MS. Intermediate risk of cardiac events and recurrent stroke after stroke admission in young adults. Int J Stroke. 2018;13(6):576–584.
    1. Goldstein LB. Accuracy of ICD-9-CM coding for the identification of patients with acute ischemic stroke: effect of modifier codes. Stroke. 1998;29(8):1602–1604.
    1. Roumie CL, Mitchel E, Gideon PS, Varas-Lorenzo C, Castellsague J, Griffin MR. Validation of ICD-9 codes with a high positive predictive value for incident strokes resulting in hospitalization using Medicaid health data. Pharmacoepidemiol Drug Saf. 2008;17(1):20–26.
    1. Kim D, Yang PS, Kim TH, Jang E, Shin H, Kim HY, Yu HT, Uhm JS, Kim JY, Pak HN, et al. Ideal blood pressure in patients with atrial fibrillation. J Am Coll Cardiol. 2018;72(11):1233–1245.
    1. Kiss Z, Rokszin G, Abonyi-Toth Z, Jermendy G, Kempler P, Aradi D, Wittmann I. Dissimilar impact of type 2 diabetes on cardiovascular outcomes according to age categories: a nationwide population study from Hungary. Cardiovasc Diabetol. 2018;17(1):107.
    1. Ohm J, Skoglund PH, Discacciati A, Sundstrom J, Hambraeus K, Jernberg T, Svensson P. Socioeconomic status predicts second cardiovascular event in 29,226 survivors of a first myocardial infarction. Eur J Prev Cardiol. 2018;25(9):985–993.
    1. Winell K, Arffman M, Pietila A, Salomaa V. Regional differences in the incidence of diabetic cardiovascular events reflect the quality of care. Scand Cardiovasc J. 2018;52(5):232–237.
    1. Pajunen P, Koukkunen H, Ketonen M, Jerkkola T, Immonen-Räihä P, Kärjä-Koskenkari P, Mähönen M, Niemelä M, Kuulasmaa K, Palomäki P, et al. The validity of the Finnish hospital discharge register and causes of death register data on coronary heart disease. Eur J Cardiovasc Prev Rehabil. 2005;12(2):132–137.
    1. Tolonen H, Salomaa V, Torppa J, Sivenius J, Immonen-Räihä P, Lehtonen A. The validation of the Finnish hospital discharge register and causes of death register data on stroke diagnoses. Eur J Cardiovasc Prev Rehabil. 2007;14(3):380–385.
    1. Yang CT, Kor CT, Hsieh YP. Long-term effects of spironolactone on kidney function and hyperkalemia-associated hospitalization in patients with chronic kidney disease. J Clin Med. 2018;7(11):459.
    1. Young JB, Gauthier-Loiselle M, Bailey RA, Manceur AM, Lefebvre P, Greenberg M, Lafeuille MH, Duh MS, Bookhart B, Wysham CH. Development of predictive risk models for major adverse cardiovascular events among patients with type 2 diabetes mellitus using health insurance claims data. Cardiovasc Diabetol. 2018;17(1):118.
    1. Arnaout R, Nah G, Marcus G, Tseng Z, Foster E, Harris IS, Divanji P, Klein L, Gonzalez J, Parikh N. Pregnancy complications and premature cardiovascular events among 1.6 million California pregnancies. Open Heart. 2019;6(1):e000927.
    1. Chen S, Hsu WY, Lin YN, Wang CY, Wu CH, Chang KH. Incidence and risk of major adverse cardiovascular events in middle-aged patients with chronic kidney disease: a population-based cohort study. Int Urol Nephrol. 2019;51(7):1219–1227.
    1. Giral P, Neumann A, Weill A, Coste J. Cardiovascular effect of discontinuing statins for primary prevention at the age of 75 years: a nationwide population-based cohort study in France. Eur Heart J. 2019;40(43):3516–3525.
    1. Hsueh CM, Wey JH, Yeh JS, Wu CH, Liou TH, Chang KH. Incidence and risk of major heart diseases in middle-aged adults with moderate to severe vision impairment: a population-based cohort study. Br J Ophthalmol. 2019;103(8):1054–1059.
    1. Kim K, Kwak A, Choi CU, Kim JH, Kim MG, Oh JM, Ji E. Differences in preventing new-onset cardiovascular events with statin therapy in seniors aged 75 years and over: a cohort study in the South Korean National Health Insurance Database. Basic Clin Pharmacol Toxicol. 2019;125(2):108–116.
    1. Kuo S, Yang CT, Wu JS, Ou HT. Effects on clinical outcomes of intensifying triple oral antidiabetic drug (OAD) therapy by initiating insulin versus enhancing OAD therapy in patients with type 2 diabetes: a nationwide population-based, propensity-score-matched cohort study. Diabetes Obes Metab. 2019;21(2):312–320.
    1. Chang CH, Lee YC, Tsai CT, Chang SN, Chung YH, Lin MS, Lin JW, Lai MS. Continuation of statin therapy and a decreased risk of atrial fibrillation/flutter in patients with and without chronic kidney disease. Atherosclerosis. 2014;232(1):224–230.
    1. Lin YS, Chen TH, Chi CC, Lin MS, Tung TH, Liu CH, Chen YL, Chen MC. Different implications of heart failure, ischemic stroke, and mortality between nonvalvular atrial fibrillation and atrial flutter-a view from a national cohort study. J Am Heart Assoc. 2017;6(7):e006406.
    1. Wu CS, Lai MS, Gau SS, Wang SC, Tsai HJ. Concordance between patient self-reports and claims data on clinical diagnoses, medication use, and health system utilization in Taiwan. PLoS One. 2014;9(12):e112257.
    1. Sung SF, Hsieh CY, Lin HJ, Chen YW, Yang YH, Li CY. Validation of algorithms to identify stroke risk factors in patients with acute ischemic stroke, transient ischemic attack, or intracerebral hemorrhage in an administrative claims database. Int J Cardiol. 2016;215:277–282.
    1. Li SY, Chen HH, Lin CL, Yeh SY, Kao CH. The different cardiovascular outcomes between long-term efficacy of hydrophilic and lipophilic statin therapy in both Asian diabetic sexes. Dose Response. 2019;17(3):1559325819876766.
    1. Mureddu GF, Greco C, Rosato S, D’Errigo P, De Luca L, Badoni G, et al. High thrombotic risk increases adverse clinical events up to 5 years after acute myocardial infarction. A nationwide retrospective cohort study. Monaldi Arch Chest Dis. 2019;89(3). 10.4081/monaldi.2019.1166.
    1. Lin Y-F, Chen L, Lin S-L, Yeh Y-C, Huang T-M, Chou Y-H, Chang F-C, Chen Y-T, Yang S-Y, Lai T-S, et al. Potential target-organ protection of mineralocorticoid receptor antagonist in acute kidney disease. J Hypertens. 2019;37(1):125–134.
    1. Bourrier M, Ferguson TW, Embil JM, Rigatto C, Komenda P, Tangri N. Peripheral artery disease: its adverse consequences with and without CKD. Am J Kidney Dis. 2020;75(5):705–712.
    1. Lin CP, Tung YC, Hsiao FC, Yang CH, Kao YW, Lin YS, et al. Fixed-dose combination of amlodipine and atorvastatin improves clinical outcomes in patients with concomitant hypertension and dyslipidemia. J Clin Hypertens (Greenwich). 2020;22:1846-53.
    1. Madsen CM, Kamstrup PR, Langsted A, Varbo A, Nordestgaard BG. Lipoprotein(a)-lowering by 50 mg/dL (105 nmol/L) may be needed to reduce cardiovascular disease 20% in secondary prevention: a population-based study. Arterioscler Thromb Vasc Biol. 2020;40(1):255–266.
    1. Petersen I, Nicolaisen SK, Ricciardi F, Sharma M, Thomsen RW, Baio G, Pedersen L. Impact of being eligible for type 2 diabetes treatment on all-cause mortality and cardiovascular events: regression discontinuity design study. Clin Epidemiol. 2020;12:569–577.
    1. Seong JM, Shin D, Sung JW, Cho S, Yang J, Kang S, Moon HW, Lee KW, Ha US. Gonadotropin-releasing hormone agonists, anti-androgens and the risk of cardio-cerebrovascular disease in prostate cancer patients: an asian population-based observational study. J Cancer. 2020;11(14):4015–4022.
    1. Freemantle N, Calvert M, Wood J, Eastaugh J, Griffin C. Composite outcomes in randomized trials: greater precision but with greater uncertainty? JAMA. 2003;289(19):2554–2559.
    1. Kip KE, Hollabaugh K, Marroquin OC, Williams DO. The problem with composite end points in cardiovascular studies: the story of major adverse cardiac events and percutaneous coronary intervention. J Am Coll Cardiol. 2008;51(7):701–707.
    1. Kerr AJ, Wang TKM, Jiang Y, Grey C, Wells S, Poppe KK. The importance of considering both primary and secondary diagnostic codes when using administrative health data to study acute coronary syndrome epidemiology (ANZACS-QI 47). Eur Heart J Qual Care Clin Outcomes. 2020;7:548-55.
    1. Peng M, Eastwood C, Boxill A, Jolley RJ, Rutherford L, Carlson K, Dean S, Quan H. Coding reliability and agreement of international classification of disease, 10(th) revision (ICD-10) codes in emergency department data. Int J Popul Data Sci. 2018;3(1):445.
    1. Chang TE, Lichtman JH, Goldstein LB, George MG. Accuracy of ICD-9-CM codes by hospital characteristics and stroke severity: Paul Coverdell National Acute Stroke Program. J Am Heart Assoc. 2016;5(6):e003056.
    1. Bush M, Sturmer T, Stearns SC, Simpson RJ, Jr, Brookhart MA, Rosamond W, Kucharska-Newton AM. Position matters: validation of medicare hospital claims for myocardial infarction against medical record review in the atherosclerosis risk in communities study. Pharmacoepidemiol Drug Saf. 2018;27(10):1085–1091.
    1. Cutrona SL, Toh S, Iyer A, Foy S, Daniel GW, Nair VP, Ng D, Butler MG, Boudreau D, Forrow S, et al. Validation of acute myocardial infarction in the Food and Drug Administration’s Mini-sentinel program. Pharmacoepidemiol Drug Saf. 2013;22(1):40–54.
    1. Ando T, Ooba N, Mochizuki M, Koide D, Kimura K, Lee SL, Setoguchi S, Kubota K. Positive predictive value of ICD-10 codes for acute myocardial infarction in Japan: a validation study at a single center. BMC Health Serv Res. 2018;18(1):895.

Source: PubMed

Sponsorit ja yhteistyökumppanit

Sairaudet

Huumeiden interventiot

3
Tilaa