A novel data mining approach to the identification of effective drugs or combinations for targeted endpoints - Application to chronic heart failure as a new form of evidence-based medicine
A novel data mining approach to the identification of effective drugs or combinations for targeted endpoints - Application to chronic heart failure as a new form of evidence-based medicine
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DOI：
10.1007/s10557-004-6226-y
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发表时间：
2004-11-01
影响因子：
3.4
通讯作者：
Kitakaze, M
中科院分区：
文献类型：
--
作者：
Kim, J;Washio, T;Kitakaze, M
背景：数据挖掘是一种发现数据库中隐藏的有用信息的技术，最近已被化学、金融、制药和保险行业使用。它可能使我们能够发现有用药物的有趣且隐藏的数据，特别是在心血管疾病领域。方法和结果：我们使用数据挖掘的决策树方法评估了我们研究所目前治疗慢性心力衰竭（CHF）的方法，并将结果与大规模临床试验的结果进行了比较。我们招募了 1,100 名过去 31 个月内在国家心血管中心住院的 CHF 患者（NYHA II - IV 级且 EF < 40%）。出院时开出的药物是从临床数据库中提取的。前瞻性测定出院后 6-12 个月的超声心动图和血浆 BNP 水平。结果发现，β-受体阻滞剂、血管紧张素转换酶抑制剂和血管紧张素 II 受体拮抗剂独立地改善血浆 BNP 水平和缩短分数 (FS) 百分比，而口服正性肌力药物则增加血浆 BNP 水平并降低 FS 百分比。这些发现与多项大规模试验中积累的证据一致。有趣的是，他汀类药物、组胺受体阻滞剂和α-葡萄糖苷酶抑制剂也减轻了CHF的严重程度，提示了CHF新疗法的可能性。结论：使用日本CHF患者进行的临床数据挖掘得到了与大规模试验结果几乎相同的数据，并且还提出了CHF治疗的新颖且意想不到的候选者。有必要进一步验证心血管领域批准的数据挖掘。
Background: Data mining is a technique for discovering useful information hidden in a database, which has recently been used by the chemical, financial, pharmaceutical, and insurance industries. It may enable us to detect the interesting and hidden data on useful drugs especially in the field of cardiovascular disease.Methods & Results: We evaluated the current treatments for chronic heart failure (CHF) in our institute using a decision tree method of data mining and compared the results with those of large-scale clinical trials. We enrolled 1,100 patients with CHF ( NYHA classes II - IV and EF < 40%) who were hospitalized at the National Cardiovascular Center during the past 31 months. Drugs prescribed at discharge were extracted from the clinical database. Both echocardiograms and plasma BNP level at 6 - 12 months after discharge were determined prospectively. It was found that beta-blockers, angiotensin converting enzyme inhibitors, and angiotensin II receptor antagonists independently improve both the plasma BNP level and % fractional shortening (FS), while oral inotropic agents increased the plasma BNP level and decreased % FS. These findings agree with evidence accumulated from several large-scale trials. Interestingly, statins, histamine receptor blockers, and alpha-glucosidase inhibitors also attenuated the severity of CHF, suggesting the possibility of new treatment of CHF.Conclusion: Clinical data mining using Japanese CHF patients yielded almost identical data to the results of large-scale trials, and also suggested novel and unexpected candidates for CHF therapy. Further validation of the data mining approved in the cardiovascular field is warranted.