TY - JOUR
TI - Ranking of stroke and cardiovascular risk factors for an optimal risk calculator design: Logistic regression approach
AU - Cuadrado-Godia, E.
AU - Jamthikar, A.D.
AU - Gupta, D.
AU - Khanna, N.N.
AU - Araki, T.
AU - Maniruzzaman, M.
AU - Saba, L.
AU - Nicolaides, A.
AU - Sharma, A.
AU - Omerzu, T.
AU - Suri, H.S.
AU - Gupta, A.
AU - Mavrogeni, S.
AU - Turk, M.
AU - Laird, J.R.
AU - Protogerou, A.
AU - Sfikakis, P.
AU - Kitas, G.D.
AU - Viswanathan, V.
AU - Suri, J.S.
JO - Computers in Biology and Medicine
PY - 2019
VL - 108
TODO - null
SP - 182-195
PB - Elsevier Ireland Ltd
SN - 0010-4825
TODO - 10.1016/j.compbiomed.2019.03.020
TODO - Regression analysis;  Ultrasonics, Cardio-vascular risk factors;  Cardiovascular risk;  Covariates;  Image-based;  Logistic regressions;  Odds ratios;  P-values;  Performance;  Ranking, Mathematical instruments, hemoglobin A1c, adult;  aged;  area under the curve;  arterial wall thickness;  Article;  B scan;  cardiovascular risk;  cerebrovascular accident;  cohort analysis;  female;  genetic association;  human;  Japanese (people);  logistic regression analysis;  long term care;  machine learning;  major clinical study;  male;  odds ratio;  phenotype;  priority journal;  receiver operating characteristic;  right common carotid artery;  stroke patient;  age;  Asian continental ancestry group;  biological model;  blood;  cerebrovascular accident;  common carotid artery;  diagnostic imaging;  echography;  Japan;  metabolism;  middle aged;  pathophysiology;  risk assessment;  very elderly, Age Factors;  Aged;  Aged, 80 and over;  Asian Continental Ancestry Group;  Carotid Artery, Common;  Female;  Humans;  Japan;  Male;  Middle Aged;  Models, Cardiovascular;  Risk Assessment;  Stroke;  Ultrasonography
TODO - Purpose: Conventional cardiovascular risk factors (CCVRFs) and carotid ultrasound image-based phenotypes (CUSIP) are independently associated with long-term risk of cardiovascular (CV) disease. In this study, 26 cardiovascular risk (CVR) factors which consisted of a combination of CCVRFs and CUSIP together were ranked. Further, an optimal risk calculator using AtheroEdge composite risk score (AECRS1.0) was designed and benchmarked against seven conventional CV risk (CVR) calculators. Methods: Two types of ranking were performed: (i) ranking of 26 CVR factors and (ii) ranking of eight types of 10-year risk calculators. In the first case, multivariate logistic regression was used to compute the odds ratio (OR) and in the second, receiver operating characteristic curves were used to evaluate the performance of eight types of CVR calculators using SPSS23.0 and MEDCALC12.0 with validation against STATA15.0. Results: The left and right common carotid arteries (CCA) of 202 Japanese patients were examined to obtain 404 ultrasound scans. CUSIP ranked in the top 50% of the 26 covariates. Intima-media thickness variability (IMTV) and IMTV 10yr were the most influential carotid phenotypes for left CCA (OR = 250, P < 0.0001 and OR = 207, P < 0.0001 respectively) and right CCA (OR = 1614, P < 0.0001 and OR = 626, P < 0.0001 respectively). However, for the mean CCA, AECRS1.0 and AECRS1.0 10yr reported the most highly significant OR among all the CVR factors (OR = 1.073, P < 0.0001 and OR = 1.104, P < 0.0001). AECRS1.0 10yr also reported highest area-under-the-curve (AUC = 0.904, P < 0.0001) compared to seven types of conventional calculators. Age and glycated haemoglobin reported highest OR (1.96, P < 0.0001 and 1.05, P = 0.012) among all other CCVRFs. Conclusion: AECRS1.0 10yr demonstrated the best performance due to presence of CUSIP and ranked at the first place with highest AUC. © 2019 Elsevier Ltd
ER -