title: Creation and Validation of an EMR-based Algorithm for Identifying Major Adverse Cardiac Events while on Statins.
abstract: Statin medications are often prescribed to ameliorate a patient's risk of cardiovascular events due in part to cholesterol reduction. We developed and evaluated an algorithm that can accurately identify subjects with major adverse cardiac events (MACE) while on statins using electronic medical record (EMR) data. The algorithm also identifies subjects experiencing their first MACE while on statins for primary prevention. The algorithm achieved 90% to 97% PPVs in identification of MACE cases as compared against physician review. By applying the algorithm to EMR data in BioVU, cases and controls were identified and used subsequently to replicate known associations with eight genetic variants. We replicated 6/8 previously reported genetic associations with cardiovascular diseases or lipid metabolism disorders. Our results demonstrated that the algorithm can be used to accurately identify subjects with MACE and MACE while on statins. Consequently, future e studies can be conducted to investigate and validate the relationship between statins and MACE using real-world clinical data.
authors.affiliation: Department of Biomedical Informatics, Vanderbilt University, Nashville, TN.
authors.forename: Wei-Qi
authors.initials: WQ
authors.lastname: Wei
authors.affiliation: Division of Clinical Pharmacology, Vanderbilt University School of Medicine, Nashville, TN.
authors.forename: Qiping
authors.initials: Q
authors.lastname: Feng
authors.affiliation: Division of Clinical Pharmacology, Vanderbilt University School of Medicine, Nashville, TN.
authors.forename: Peter
authors.initials: P
authors.lastname: Weeke
authors.affiliation: Center for Human Genetics Research, Vanderbilt University Medical Center, Nashville, TN.
authors.forename: William
authors.initials: W
authors.lastname: Bush
authors.affiliation: Division of Clinical Pharmacology, Vanderbilt University School of Medicine, Nashville, TN.
authors.forename: Magarya S
authors.initials: MS
authors.lastname: Waitara
authors.affiliation: Division of Clinical Pharmacology, Vanderbilt University School of Medicine, Nashville, TN.
authors.forename: Otito F
authors.initials: OF
authors.lastname: Iwuchukwu
authors.affiliation: Division of Clinical Pharmacology, Vanderbilt University School of Medicine, Nashville, TN ; Oates Institute for Experimental Therapeutics, Vanderbilt University, Nashville, TN ; Office of Personalized Medicine, Vanderbilt University, Nashville, TN.
authors.forename: Dan M
authors.initials: DM
authors.lastname: Roden
authors.affiliation: Department of Internal Medicine, Sanford Healthcare, Fargo, ND.
authors.forename: Russell A
authors.initials: RA
authors.lastname: Wilke
authors.affiliation: Division of Clinical Pharmacology, Vanderbilt University School of Medicine, Nashville, TN.
authors.forename: Charles M
authors.initials: CM
authors.lastname: Stein
authors.affiliation: Department of Biomedical Informatics, Vanderbilt University, Nashville, TN.
authors.forename: Joshua C
authors.initials: JC
authors.lastname: Denny