Phenome-Wide Association Studies Uncover a Novel Association of Increased Atrial Fibrillation in Male Patients With Systemic Lupus Erythematosus.

Phenome-Wide Association Studies Uncover a Novel Association of Increased Atrial Fibrillation in Male Patients With Systemic Lupus Erythematosus.
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DOI:
10.1002/acr.23553
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发表时间:
2018-11
影响因子:
4.7
通讯作者:
Crofford LJ
Crofford LJ
中科院分区:
医学2区
文献类型:
--
作者:
Barnado A;Carroll RJ;Casey C;Wheless L;Denny JC;Crofford LJ

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全表型关联研究 (PheWAS) 扫描电子健康记录 (EHR) 中的计费代码,并重新利用临床 EHR 数据进行研究。我们研究了 PheWAS 是否可以作为 SLE 的 EHR 发现工具,并揭示男性与女性 SLE 患者的新临床关联。我们使用了范德比尔特大学医学中心 EHR 的去识别版本,其中包含超过 280 万受试者。我们进行了 PheWAS 比较 1) SLE 病例与年龄、性别和种族匹配对照以及 2) 男性与女性 SLE 病例,并使用 0.05 的错误发现率 (FDR) 进行多重测试对照。我们确定了 1097 名 SLE 受试者和 5735 名匹配的对照。将 SLE 病例与匹配对照相比,SLE 病例更有可能具有 SLE 疾病标准代码。在针对年龄和种族进行调整的男性与女性 SLE 病例 PheWAS 中,男性更有可能患有心房颤动 (AF) OR = 4.50 (FDR p = 3.23 × 10−3)。图表回顾了已确诊的 AF,大多数受试者在 SLE 诊断后出现 AF,并且具有多种 AF 危险因素。调整年龄、性别、种族和冠状动脉疾病 (CAD) 后,SLE 疾病与 AF 显着相关 (p = 0.002)。使用 PheWAS 比较患有 SLE 的男性和女性,我们发现了 SLE 男性中 AF 增加的新关联。即使在调整了年龄、性别、种族和 CAD 后,SLE 疾病状态也与 AF 独立相关。这些结果证明了 PheWAS 作为 SLE 的 EHR 发现工具的实用性。
Phenome-wide association studies (PheWAS) scan across billing codes in the electronic health record (EHR) and re-purpose clinical EHR data for research. We examined if PheWAS could function as an EHR discovery tool for SLE and uncover novel clinical associations in male versus female SLE patients. We used a de-identified version of the Vanderbilt University Medical Center EHR with over 2.8 million subjects. We performed PheWAS comparing 1) SLE cases vs. age, sex, and race-matched controls and 2) male vs. female SLE cases and controlled for multiple testing using a false discovery rate (FDR) of 0.05. We identified 1097 SLE subjects and 5735 matched controls. Comparing SLE cases to matched controls, SLE cases were more likely to have codes for SLE disease criteria. In the male vs. female SLE case-only PheWAS adjusting for age and race, males were more likely to have atrial fibrillation (AF) OR = 4.50 (FDR p = 3.23 × 10−3). Chart reviewed confirmed AF with the majority of subjects developing AF after SLE diagnosis and having multiple risk factors for AF. Adjusting for age, sex, race, and coronary artery disease (CAD), SLE disease was significantly associated with AF (p = 0.002). Using PheWAS to compare males vs. females with SLE, we uncovered a novel association of increased AF in SLE males. SLE disease status was independently associated with AF even after adjusting for age, sex, race, and CAD. These results demonstrate the utility of PheWAS as an EHR discovery tool for SLE.
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