Patients with stable coronary artery disease and type 2 diabetes but without prior myocardial infarction or stroke and THEMIS-like patients: real-world prevalence and risk of major outcomes from the SNDS French nationwide claims database

Abstract Aim and hypotheses The THEMIS randomized trial compared ticagrelor plus aspirin versus placebo plus aspirin for patients with stable coronary artery disease and type 2 diabetes mellitus (CAD-T2DM), and without prior myocardial infarction (MI) or stroke. The aim of the study was to quantify...

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Autores principales:	Patrick Blin, Patrice Darmon, Patrick Henry, Estelle Guiard, Marie-Agnès Bernard, Caroline Dureau-Pournin, Hélène Maizi, Florence Thomas-Delecourt, Régis Lassalle, Cécile Droz-Perroteau, Nicholas Moore
Formato:	article
Lenguaje:	EN
Publicado:	BMC 2021
Materias:	Coronary artery disease Type 2 diabetes mellitus Prevalence Myocardial infarction Stroke Mortality Diseases of the circulatory (Cardiovascular) system RC666-701
Acceso en línea:	https://doaj.org/article/ad92aa4d41ef458d8ee27316b77cfc3f
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spelling	oai:doaj.org-article:ad92aa4d41ef458d8ee27316b77cfc3f2021-11-28T12:14:08ZPatients with stable coronary artery disease and type 2 diabetes but without prior myocardial infarction or stroke and THEMIS-like patients: real-world prevalence and risk of major outcomes from the SNDS French nationwide claims database10.1186/s12933-021-01416-11475-2840https://doaj.org/article/ad92aa4d41ef458d8ee27316b77cfc3f2021-11-01T00:00:00Zhttps://doi.org/10.1186/s12933-021-01416-1https://doaj.org/toc/1475-2840Abstract Aim and hypotheses The THEMIS randomized trial compared ticagrelor plus aspirin versus placebo plus aspirin for patients with stable coronary artery disease and type 2 diabetes mellitus (CAD-T2DM), and without prior myocardial infarction (MI) or stroke. The aim of the study was to quantify the size of the CAD-T2DM population without prior MI or stroke population in a real-world setting, and more specifically populations with similar THEMIS selection criteria (THEMIS-like and THEMIS-PCI-like populations), as well as their risk of major outcomes in current practice. Methods A 2-year follow-up cohort study included all CAD-T2DM without MI/stroke prevalent patients on January 1st, 2014 in the SNDS French nationwide claims database. The THEMIS-like population concerned those ≥ 50 years of age with similar THEMIS inclusion and exclusion criteria. Prevalence was standardized to the European population. The cumulative incidence function was used to estimate the incidence of clinical outcomes (MI, ischemic stroke, and major bleeding according to the TIMI classification) with death as competing risk, and the Kaplan–Meier estimate for all-cause death and a composite outcome of MI, stroke and all-cause death. Results From a population of about 50 million adults, the prevalence of CAD-T2DM without MI/stroke, THEMIS-like and THEMIS-PCI-like populations was respectively at 6.04, 1.50 and 0.27 per 1000 adults, with a mean age of 72.7, 72.3 and 70.9 years and less comorbidities and diabetic complications for the THEMIS-like and THEMIS-PCI-like population. The 2-year cumulative incidence was respectively 1.7%, 1.3% and 1.6% for MI, 1.7%, 1.5% and 1.4% for stroke, 4.8%, 3.1% and 2.9% for major bleeding, 13.6%, 9.7% and 6.8% for all-cause death, and 16.2%, 12.0% and 9.5% for the composite outcome. Conclusion THEMIS-like prevalence was estimated at 1.50 per 1,000 adults, representing about a quarter of CAD-T2DM without MI/stroke patients, and 0.27 per 1000 adults for the THEMIS-PCI-like populations. In current French practice, the median age of both these populations was about 5–6 years older than in the THEMIS trial, with a 2-year incidence of major outcomes between two or four time above the ones of the placebo arm of the THEMIS trial using very close definitions. Registration No. EUPAS27402 ( http://www.ENCEPP.eu ).Patrick BlinPatrice DarmonPatrick HenryEstelle GuiardMarie-Agnès BernardCaroline Dureau-PourninHélène MaiziFlorence Thomas-DelecourtRégis LassalleCécile Droz-PerroteauNicholas MooreBMCarticleCoronary artery diseaseType 2 diabetes mellitusPrevalenceMyocardial infarctionStrokeMortalityDiseases of the circulatory (Cardiovascular) systemRC666-701ENCardiovascular Diabetology, Vol 20, Iss 1, Pp 1-11 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Coronary artery disease Type 2 diabetes mellitus Prevalence Myocardial infarction Stroke Mortality Diseases of the circulatory (Cardiovascular) system RC666-701
spellingShingle	Coronary artery disease Type 2 diabetes mellitus Prevalence Myocardial infarction Stroke Mortality Diseases of the circulatory (Cardiovascular) system RC666-701 Patrick Blin Patrice Darmon Patrick Henry Estelle Guiard Marie-Agnès Bernard Caroline Dureau-Pournin Hélène Maizi Florence Thomas-Delecourt Régis Lassalle Cécile Droz-Perroteau Nicholas Moore Patients with stable coronary artery disease and type 2 diabetes but without prior myocardial infarction or stroke and THEMIS-like patients: real-world prevalence and risk of major outcomes from the SNDS French nationwide claims database
description	Abstract Aim and hypotheses The THEMIS randomized trial compared ticagrelor plus aspirin versus placebo plus aspirin for patients with stable coronary artery disease and type 2 diabetes mellitus (CAD-T2DM), and without prior myocardial infarction (MI) or stroke. The aim of the study was to quantify the size of the CAD-T2DM population without prior MI or stroke population in a real-world setting, and more specifically populations with similar THEMIS selection criteria (THEMIS-like and THEMIS-PCI-like populations), as well as their risk of major outcomes in current practice. Methods A 2-year follow-up cohort study included all CAD-T2DM without MI/stroke prevalent patients on January 1st, 2014 in the SNDS French nationwide claims database. The THEMIS-like population concerned those ≥ 50 years of age with similar THEMIS inclusion and exclusion criteria. Prevalence was standardized to the European population. The cumulative incidence function was used to estimate the incidence of clinical outcomes (MI, ischemic stroke, and major bleeding according to the TIMI classification) with death as competing risk, and the Kaplan–Meier estimate for all-cause death and a composite outcome of MI, stroke and all-cause death. Results From a population of about 50 million adults, the prevalence of CAD-T2DM without MI/stroke, THEMIS-like and THEMIS-PCI-like populations was respectively at 6.04, 1.50 and 0.27 per 1000 adults, with a mean age of 72.7, 72.3 and 70.9 years and less comorbidities and diabetic complications for the THEMIS-like and THEMIS-PCI-like population. The 2-year cumulative incidence was respectively 1.7%, 1.3% and 1.6% for MI, 1.7%, 1.5% and 1.4% for stroke, 4.8%, 3.1% and 2.9% for major bleeding, 13.6%, 9.7% and 6.8% for all-cause death, and 16.2%, 12.0% and 9.5% for the composite outcome. Conclusion THEMIS-like prevalence was estimated at 1.50 per 1,000 adults, representing about a quarter of CAD-T2DM without MI/stroke patients, and 0.27 per 1000 adults for the THEMIS-PCI-like populations. In current French practice, the median age of both these populations was about 5–6 years older than in the THEMIS trial, with a 2-year incidence of major outcomes between two or four time above the ones of the placebo arm of the THEMIS trial using very close definitions. Registration No. EUPAS27402 ( http://www.ENCEPP.eu ).
format	article
author	Patrick Blin Patrice Darmon Patrick Henry Estelle Guiard Marie-Agnès Bernard Caroline Dureau-Pournin Hélène Maizi Florence Thomas-Delecourt Régis Lassalle Cécile Droz-Perroteau Nicholas Moore
author_facet	Patrick Blin Patrice Darmon Patrick Henry Estelle Guiard Marie-Agnès Bernard Caroline Dureau-Pournin Hélène Maizi Florence Thomas-Delecourt Régis Lassalle Cécile Droz-Perroteau Nicholas Moore
author_sort	Patrick Blin
title	Patients with stable coronary artery disease and type 2 diabetes but without prior myocardial infarction or stroke and THEMIS-like patients: real-world prevalence and risk of major outcomes from the SNDS French nationwide claims database
title_short	Patients with stable coronary artery disease and type 2 diabetes but without prior myocardial infarction or stroke and THEMIS-like patients: real-world prevalence and risk of major outcomes from the SNDS French nationwide claims database
title_full	Patients with stable coronary artery disease and type 2 diabetes but without prior myocardial infarction or stroke and THEMIS-like patients: real-world prevalence and risk of major outcomes from the SNDS French nationwide claims database
title_fullStr	Patients with stable coronary artery disease and type 2 diabetes but without prior myocardial infarction or stroke and THEMIS-like patients: real-world prevalence and risk of major outcomes from the SNDS French nationwide claims database
title_full_unstemmed	Patients with stable coronary artery disease and type 2 diabetes but without prior myocardial infarction or stroke and THEMIS-like patients: real-world prevalence and risk of major outcomes from the SNDS French nationwide claims database
title_sort	patients with stable coronary artery disease and type 2 diabetes but without prior myocardial infarction or stroke and themis-like patients: real-world prevalence and risk of major outcomes from the snds french nationwide claims database
publisher	BMC
publishDate	2021
url	https://doaj.org/article/ad92aa4d41ef458d8ee27316b77cfc3f
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Patients with stable coronary artery disease and type 2 diabetes but without prior myocardial infarction or stroke and THEMIS-like patients: real-world prevalence and risk of major outcomes from the SNDS French nationwide claims database

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