Author:
Huang Xiao-Dong,Lin Ji-Yan,Huang Xian-Wei,Zhou Ting-Ting,Xie Liang-Di
Abstract
Abstract
Background
There is currently a lack of a precise, concise, and practical clinical prediction model for predicting coronary artery disease (CAD) in patients with essential hypertension (EH). This study aimed to construct a nomogram to predict CAD in patients with EH based on flow-mediated dilation (FMD) of brachial artery and traditional risk factors.
Methods
Clinical data of 1752 patients with EH were retrospectively collected. High-resolution vascular ultrasound was used to detect FMD in all patients at the Fujian Hypertension Research Institute, China. Patients were divided into two groups, i.e. training group (n = 1204, from August 2000 to December 2013) and validation group (n = 548, from January 2014 to May 2016) according to the time of enrollment. Independent predictors of CAD were analyzed by multivariable logistic regression in the training group, and a nomogram was constructed accordingly. Finally, we evaluated the discrimination, calibration, and clinical applicability of the model using the area under curve (AUC) of receiver operating characteristic analysis, calibration curve combined with Hosmer-Lemeshow test, and decision curve, respectively.
Results
There were 263 (21.8%) cases of EH combined with CAD in the training group. Multivariate logistic regression showed that FMD, age, duration of EH, waist circumference, and diabetes mellitus were independent influencing factors for CAD in EH patients. Smoking which was close to statistical significance (P = 0.062) was also included in the regression model to increase the accuracy. Ultimately, the nomogram for predicting CAD in EH patients was constructed according to above predictors after proper transformation. The AUC values of the training group and the validation group were 0.799 (95%CI 0.770–0.829) and 0.836 (95%CI 0.787–0.886), respectively. Calibration curve and Hosmer-Lemeshow test showed that the model had good calibration (training group: χ2 = 0.55, P = 0.759; validation group: χ2 = 1.62, P = 0.446). The decision curve also verified the clinical applicability of the nomogram.
Conclusion
The nomogram based on FMD and traditional risk factors (age, duration of EH disease, smoking, waist circumference and diabetes mellitus) can predict CAD high-risk group among patients with EH.
Publisher
Springer Science and Business Media LLC
Subject
Cardiology and Cardiovascular Medicine
Reference32 articles.
1. Global. burden of 87 risk factors in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet (London, England) 2020, 396(10258):1223–1249.
2. The Writing Committee of the Report on Cardiovascular Health and Diseases in China. Report on Cardiovascular Health and Diseases in China 2021: an updated Summary. Chin Circulation J. 2022;37(6):553–78.
3. Liu X, Shen P, Zhang D, Sun Y, Chen Y, Liang J, Wu J, Zhang J, Lu P, Lin H, et al. Evaluation of atherosclerotic Cardiovascular Risk Prediction Models in China: results from the CHERRY Study. JACC Asia. 2022;2(1):33–43.
4. Clark D 3rd, Colantonio LD, Min YI, Hall ME, Zhao H, Mentz RJ, Shimbo D, Ogedegbe G, Howard G, Levitan EB, et al. Population-Attributable Risk for Cardiovascular Disease Associated with hypertension in black adults. JAMA Cardiol. 2019;4(12):1194–202.
5. Yang X, Li J, Hu D, Chen J, Li Y, Huang J, Liu X, Liu F, Cao J, Shen C, et al. Predicting the 10-Year risks of atherosclerotic Cardiovascular Disease in Chinese Population: the China-PAR Project (Prediction for ASCVD Risk in China). Circulation. 2016;134(19):1430–40.
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