Disease network delineates the disease progression profile of cardiovascular diseases

Abstract

Objective: As Electronic Health Records (EHR) data accumulated explosively in recent years, the tremendous amount of patient clinical data provided opportunities to discover real world evidence. In this study, a graphical disease network, named progressive cardiovascular disease network (progCDN), was built to delineate the progression profiles of cardiovascular diseases (CVD). Materials and Methods: The EHR data of 14.3 million patients with CVD diagnoses were collected for building disease network and further analysis. We applied a new designed method, progression rates (PR), to calculate the progression relationship among different diagnoses. Based on the disease network outcome, 23 disease progression pair were selected to screen for salient features. Results: The network depicted the dominant diseases in CVD development, such as the heart failure and coronary arteriosclerosis. Novel progression relationships were also discovered, such as the progression path from long QT syndrome to major depression. In addition, three age-group progCDNs identified a series of age-associated disease progression paths and important successor diseases with age bias. Furthermore, a list of important features with sufficient abundance and high correlation was extracted for building disease risk models. Discussion: The PR method designed for identifying the progression relationship could be widely applied in any EHR database due to its flexibility and robust functionality. Meanwhile, researchers could use the progCDN network to validate or explore novel disease relationships in real world data. Conclusion: The first-time interrogation of such a huge CVD patients cohort enabled us to explore the general and age-specific disease progression patterns in CVD development.