Constructing Large Scale Cohort for Clinical Study on Heart Failure with Electronic Health Record in Regional Healthcare Platform: Challenges and Strategies in Data Reuse

Publication date: June 2019Source: Chinese Medical Sciences Journal, Volume 34, Issue 2Author(s): Daowen Liu, Liqi Lei, Tong Ruan, Ping HeAbstractRegional healthcare platforms collect clinical data from hospitals in specific areas for the purpose of healthcare management. It is a common requirement to reuse the data for clinical research. However, we have to face challenges like the inconsistence of terminology in electronic health records (EHR) and the complexities in data quality and data formats in regional healthcare platform. In this paper, we propose methodology and process on constructing large scale cohorts which forms the basis of causality and comparative effectiveness relationship in epidemiology. We firstly constructed a Chinese terminology knowledge graph to deal with the diversity of vocabularies on regional platform. Secondly, we built special disease case repositories (i.e., heart failure repository) that utilize the graph to search the related patients and to normalize the data. Based on the requirements of the clinical research which aimed to explore the effectiveness of taking statin on 180-days readmission in patients with heart failure, we built a large-scale retrospective cohort with 29647 cases of heart failure patients from the heart failure repository. After the propensity score matching, the study group (n=6346) and the control group (n=6346) with parallel clinical characteristics were acquired. Logistic regression analysis showed that taking statins...
Source: Chinese Medical Sciences Journal - Category: General Medicine Source Type: research

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Conclusions: The ACO cohort with statin use exhibited the lower risk of hepatic, renal, and heart failure than any other cohort, regardless of age, sex, comorbidities, or ICS or OS use. Regarding the combined use of statins and ICS, the risks of hepatic failure were lower. For the combined use of statins and OS, the hepatic, renal and heart failure were less frequent.
Source: Frontiers in Pharmacology - Category: Drugs & Pharmacology Source Type: research
Abstract Heart failure is a common medical problem in the world, which has a high prevalence in both developed and developing countries. Today, among the medications used for the heart failure treatment, there are many medications with a positive cardiac contraction effect (positive inotropic such as digital glycosides, adrenergic receptor stimulants, and phosphodiesterase inhibitors), a large number of cardiac diluents (such as Angiotensin-converting enzyme (ACE) inhibitor group), and a few other types of drugs whose final effects are still under review Statins are valuable drugs that are broadly prescribed in hy...
Source: Current Clinical Pharmacology - Category: Drugs & Pharmacology Authors: Tags: Curr Clin Pharmacol Source Type: research
Statin therapy is necessary for secondary prevention in patients with acute myocardial infarction (AMI). However, among patients with ischemic heart failure (HF) with reduced ejection fraction (EF) who suffered from AMI before 1 year, limited data are available describing the clinical impact of statin withdrawal within 1 year after AMI.
Source: Journal of Cardiac Failure - Category: Cardiology Authors: Tags: 143 Source Type: research
Authors: Fu S, Ping P, Ye P, Luo L Abstract BACKGROUND: This analysis was designed to investigate the relationship between drug application and mortality rate in Chinese older coronary artery disease (CAD)/chronic heart failure (CHF) patients with and without low glomerular filtration rate (GFR). METHODS: All 1050 Chinese hospitalized patients with diagnosed CAD were included in this analysis, and Cox Regression was used to analyze the relationship between drug application and mortality rate after multivariate adjustment. Low GFR was defined as GFR 
Source: BMC Pharmacology and Toxicology - Category: Drugs & Pharmacology Tags: BMC Pharmacol Toxicol Source Type: research
AbstractPurpose of ReviewWe summarize the best evidence for statins in the prevention and treatment of heart failure.Recent FindingsIn patients with cardiovascular risk factors or established atherosclerotic cardiovascular disease (but without heart failure), statins reduce the risk of incident heart failure —mainly by preventing myocardial infarction although an additional benefit from reducing myocardial ischemia cannot be excluded. However, in patients with established heart failure, statins do not reduce the risk of cardiovascular death, which is mainly caused by pump failure and ventricular arrhy thmias. Retrosp...
Source: Current Atherosclerosis Reports - Category: Cardiology Source Type: research
Purpose of review Uncertainty persists about the contribution of lipids to the increased risk of cardiovascular disease (CVD) among rheumatoid arthritis and other inflammatory joint disease (IJD) patients. In reviewing recent research, we consider potential insights gained by quantifying lipoprotein particles directly, rather than by their lipid content. Recent findings Although inflammation often decreases LDL cholesterol (LDL-C), and anti-inflammatory medications often increase LDL-C, both inflammation and anti-inflammatory medications can increase atherogenic Apolipoprotein B (ApoB)-containing lipoprotein particles...
Source: Current Opinion in Lipidology - Category: Lipidology Tags: HYPERLIPIDAEMIA AND CARDIOVASCULAR DISEASE: Edited by Paul N. Durrington Source Type: research
By WILLIAM H. BESTERMANN JR., MD New Scientific Breakthroughs Can Provide a Longer Healthier Life Twenty-one years of follow-up comparing usual care with a protocol-driven team-based intervention in diabetes proved that healthy life in humans can be prolonged by 8 years. These results were achieved at a lower per patient per year cost. Aging researchers have been confident that we will soon be able to prolong healthy life. This landmark study shows this ambitious goal can be achieved now with lifestyle intervention and a few highly effective proven medications. These medications interfere with the core molecular biol...
Source: The Health Care Blog - Category: Consumer Health News Authors: Tags: Medical Practice Patients aging chronic disease Denmark Diabetes William Bestermann Source Type: blogs
ConclusionsOlder age, history of atrial fibrillation and pneumonia are associated with increased risk of influenza-associated in-hospital and 90-day mortality. Statin use may decrease 90-day mortality.
Source: Infection - Category: Infectious Diseases Source Type: research
Abstract Patients with atherosclerotic cardiovascular disease (ASCVD) and concomitant diabetes are at particularly high risk for new and recurrent ischemic events and heart failure and therefore derive greater absolute benefit from secondary prevention therapies than patients without concomitant diabetes.1 Prior analyses reported suboptimal use of evidence-based therapies in this vulnerable group1, 2 but did not include data on newer lipid and glucose-lowering therapies. Given the emergence of non-statin LDL lowering agents and glucose-lowering medications with cardiovascular benefits, the number of evidence-based...
Source: Circulation - Category: Cardiology Authors: Tags: Circulation Source Type: research
Abstract The appropriate treatment for patients with coexistent chronic obstructive pulmonary disease (COPD) and heart failure (HF) remains unclear. Data from the Taiwan National Health Insurance Research Database was used for this retrospective cohort study. Patients diagnosed with both diseases between 1997 and 2012 were enrolled as the COPD-heart failure overlap cohort. Patients were categorized as non-users and users of specific COPD and HF medications. Medication prescriptions in each 3-month and 1-year period served as time-dependent covariates. The primary endpoint was cumulative survival. The validation st...
Source: Aging - Category: Biomedical Science Authors: Tags: Aging (Albany NY) Source Type: research
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