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在美国两个大型医疗系统的电子健康记录中,肝素治疗与阿尔茨海默病痴呆症的诊断延迟有关。

Heparin treatment is associated with a delayed diagnosis of Alzheimer's dementia in electronic health records from two large United States health systems.

作者信息

Readhead Benjamin, Klang Eyal, Gisladottir Undina, Vandromme Maxence, Li Li, Quiroz Yakeel T, Arboleda-Velasquez Joseph F, Dudley Joel T, Tatonetti Nicholas P, Glicksberg Benjamin S, Reiman Eric M

机构信息

ASU-Banner Neurodegenerative Disease Research Center, Arizona State University, Tempe, AZ, 85281, USA.

Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA.

出版信息

Mol Psychiatry. 2025 Apr;30(4):1461-1465. doi: 10.1038/s41380-024-02757-5. Epub 2024 Oct 8.

Abstract

Recent studies suggest that heparan sulfate proteoglycans (HSPG) contribute to the predisposition to, protection from, and potential treatment and prevention of Alzheimer's disease (AD). Here, we used electronic health records (EHR) from two different health systems to examine whether heparin therapy was associated with a delayed diagnosis of AD dementia. Longitudinal EHR data from 15,183 patients from the Mount Sinai Health System (MSHS) and 6207 patients from Columbia University Medical Center (CUMC) were used in separate survival analyses to compare those who did or did not receive heparin therapy, had a least 5 years of observation, were at least 65 years old by their last visit, and had subsequent diagnostic code or drug treatment evidence of possible AD dementia. Analyses controlled for age, sex, comorbidities, follow-up duration and number of inpatient visits. Heparin therapy was associated with significant delays in age of clinical diagnosis of AD dementia, including +1.0 years in the MSMS cohort (P < 0.001) and +1.0 years in the CUMC cohort (P < 0.001). While additional studies are needed, this study supports the potential roles of heparin-like drugs and HSPGs in the protection from and prevention of AD dementia.

摘要

近期研究表明,硫酸乙酰肝素蛋白聚糖(HSPG)在阿尔茨海默病(AD)的易感性、防护以及潜在治疗和预防方面发挥作用。在此,我们利用来自两个不同医疗系统的电子健康记录(EHR),来检验肝素治疗是否与AD痴呆的延迟诊断相关。来自西奈山医疗系统(MSHS)的15183名患者以及哥伦比亚大学医学中心(CUMC)的6207名患者的纵向EHR数据,被用于各自的生存分析,以比较那些接受或未接受肝素治疗、至少有5年观察期、最后一次就诊时至少65岁且随后有可能的AD痴呆诊断代码或药物治疗证据的患者。分析对年龄、性别、合并症、随访时长和住院就诊次数进行了控制。肝素治疗与AD痴呆临床诊断年龄的显著延迟相关,在MSMS队列中延迟1.0年(P<0.001),在CUMC队列中延迟1.0年(P<0.001)。虽然还需要进一步研究,但本研究支持类肝素药物和HSPG在预防和防止AD痴呆方面的潜在作用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3e94/11919696/c720c567cbb9/41380_2024_2757_Fig1_HTML.jpg

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