cardio mohs supplemental methods

The CVD cohort included patients with a concurrent diagnosis of cardiovascular disease, including hypertension (ICD-10: I10-I15), hypertensive crisis (I16), or ischemic heart disease (I20-I25), whereas the non-CVD cohort consisted of patients with similar skin cancer diagnoses and Mohs procedures but without any history of these cardiovascular conditions. The study population was limited to patients whose diagnoses and procedures occurred between January 1, 2015, and December 31, 2023.

Patients with an index event occurring more than 20 years prior to the study period were excluded. The index event was defined as the date of the first recorded visit (TNX:Visit) associated with both the skin cancer diagnosis and the Mohs micrographic surgery procedure. A follow-up visit (CVD f/u) was required within six months after the initial visit to ensure patients remained engaged with healthcare services and to capture subsequent cardiovascular events.

The time window for outcomes assessment began one day after the index event and extended 30 days and 3-months postoperatively. The primary outcomes included acute myocardial infarction (AMI; ICD-10: I21) and stroke (ICD-10: I63.9). Patients who had a documented history of these outcomes before the study time window were excluded from the risk analysis and survival analysis.

To minimize confounding, propensity score matching (PSM) was performed at a 1:1 ratio between the CVD and non-CVD cohorts. Matching variables included age, sex, race, ethnicity, comorbid conditions (hypertension, diabetes, chronic kidney disease, hyperlipidemia, obesity), medication use (anticoagulants, beta-blockers, lipid-lowering agents), and laboratory values (e.g., tobacco smoking status). After matching, each cohort consisted of 27,758 patients.

The study employed multiple statistical approaches to compare outcomes between the cohorts. Risk analysis was performed to calculate risk differences, risk ratios, and odds ratios for AMI and stroke. Kaplan-Meier survival analysis was conducted to assess differences in survival probability, applying censoring to account for patients lost to follow-up.

Number of instances analysis was used to quantify the frequency of AMI and stroke occurrences within the 30-day and 3-month time window.