Oral anticoagulant treatment in atrial fibrillation: the AFIRMA real-world study using natural language processing and machine learning.
Rev Clin Esp (Barc)
; 224(7): 428-436, 2024.
Article
en En
| MEDLINE
| ID: mdl-38849073
ABSTRACT
INTRODUCTION:
Oral anticoagulation (OAC) is key in atrial fibrillation (AF) thromboprophylaxis, but Spain lacks substantial real-world evidence. We aimed to analyze the prevalence, clinical characteristics, and treatment patterns among patients with AF undertaking OAC, using natural language processing (NLP) and machine learning (ML). MATERIALS ANDMETHODS:
This retrospective study included AF patients on OAC from 15 Spanish hospitals (2014-2020). Using EHRead® (including NLP and ML), and SNOMED_CT, we extracted and analyzed patient demographics, comorbidities, and OAC treatment from electronic health records. AF prevalence was estimated, and a descriptive analysis was conducted.RESULTS:
Among 4,664,224 patients in our cohort, AF prevalence ranged from 1.9% to 2.9%. A total of 57,190 patients on OAC therapy were included, 80.7% receiving Vitamin K antagonists (VKA) and 19.3% Direct-acting OAC (DOAC). The median age was 78 and 76 years respectively, with males constituting 53% of the cohort. Comorbidities like hypertension (76.3%), diabetes (48.0%), heart failure (42.2%), and renal disease (18.7%) were common, and more frequent in VKA users. Over 50% had a high CHA2DS2-VASc score. The most frequent treatment switch was from DOAC to acenocoumarol (58.6% to 70.2%). In switches from VKA to DOAC, apixaban was the most chosen (35.2%).CONCLUSIONS:
Utilizing NLP and ML to extract RWD, we established the most comprehensive Spanish cohort of AF patients with OAC to date. Analysis revealed a high AF prevalence, patient complexity, and a marked VKA preference over DOAC. Importantly, in VKA to DOAC transitions, apixaban was the favored option.Palabras clave
Antagonistas de la vitamina K; Anticoagulación oral; Anticoagulantes orales directos; Aprendizaje automático; Artificial intelligence; Atrial fibrillation; Direct oral anticoagulants; Evidencia en el mundo real; Fibrilación auricular; Inteligencia artificial; Machine learning; Natural language processing; Oral anticoagulation; Procesamiento del lenguaje natural; Real-world evidence; Vitamin K antagonists
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Fibrilación Atrial
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Procesamiento de Lenguaje Natural
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Aprendizaje Automático
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Anticoagulantes
Límite:
Aged
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Aged80
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Female
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Humans
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Male
/
Middle aged
País/Región como asunto:
Europa
Idioma:
En
Revista:
Rev Clin Esp (Barc)
Año:
2024
Tipo del documento:
Article
Pais de publicación:
España