Meiqi He1, James M Stevenson2, Yuting Zhang3, Inmaculada Hernandez1. 1. Department of Pharmacy and Therapeutics, School of Pharmacy, University of Pittsburgh, Pittsburgh, PA, USA. 2. Division of Clinical Pharmacology, The Johns Hopkins School of Medicine, Baltimore, MD, USA. 3. Melbourne Institute, Applied Economics and Social Research, Faculty of Business and Economics, University of Melbourne, Victoria, Australia.
Abstract
OBJECTIVE: To identify characteristics associated with an increased risk of cardiovascular events in patients diagnosed with Alzheimer disease (AD) and treated with antidementia medications. METHODS: Demographics, diagnoses, and medication usage of 30 433 Medicare patients were analyzed using 2006 to 2013 claims data and a combined model of screening, ranking and stepwise logistic regressions to evaluate factors associated with composite outcomes of 6 cardiovascular events. RESULTS: Incidence rate of at least 1 cardiovascular event was 25.1%. Fifty-five factors were identified from the 10 381 candidate variables by the combined model with a c-statistic of 67% and an accuracy of 75%. Factors associated with increased risk of cardiovascular events include history of heart rhythm disorders, alteration of consciousness (odds ratio [OR]: 1.25; 95% confidence interval [CI]: 1.14-1.36), and usage of β-blockers (OR: 1.19; 95% CI: 1.13-1.27). CONCLUSIONS: Clinicians should consider the increased risk of cardiovascular events in patients with AD with heart rhythm disorders and on β-blockers.
OBJECTIVE: To identify characteristics associated with an increased risk of cardiovascular events in patients diagnosed with Alzheimer disease (AD) and treated with antidementia medications. METHODS: Demographics, diagnoses, and medication usage of 30 433 Medicare patients were analyzed using 2006 to 2013 claims data and a combined model of screening, ranking and stepwise logistic regressions to evaluate factors associated with composite outcomes of 6 cardiovascular events. RESULTS: Incidence rate of at least 1 cardiovascular event was 25.1%. Fifty-five factors were identified from the 10 381 candidate variables by the combined model with a c-statistic of 67% and an accuracy of 75%. Factors associated with increased risk of cardiovascular events include history of heart rhythm disorders, alteration of consciousness (odds ratio [OR]: 1.25; 95% confidence interval [CI]: 1.14-1.36), and usage of β-blockers (OR: 1.19; 95% CI: 1.13-1.27). CONCLUSIONS: Clinicians should consider the increased risk of cardiovascular events in patients with AD with heart rhythm disorders and on β-blockers.
Entities:
Keywords:
Medicare; antidementia therapy; cardiovascular event; claims; data mining
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