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Development and Validation of a Novel Model for Predicting Coronary Heart Disease in Snoring Hypertensive Patients
Jianwen Zhao1, Menghui Wang1, Nanfang Li1
1Hypertension Center of People's Hospital of Xinjiang Uygur Autonomous Region.
Insights
This study created a nomogram to identify high-risk coronary heart disease (CHD) in hypertensive patients who snore and have high homocysteine. The tool helps clinicians quickly find patients needing early intervention for better outcomes.
Area of Science:
- Cardiology
- Preventive Medicine
- Biostatistics
Background:
- Hypertension, snoring, and elevated plasma homocysteine are common and increase coronary heart disease (CHD) risk.
- Early identification of high-risk individuals is crucial for effective intervention.
Purpose of the Study:
- To develop and validate a user-friendly nomogram for predicting high-risk CHD in patients with hypertension, snoring, and hyperhomocysteinemia.
- To provide a clinical tool for early risk stratification.
Main Methods:
- A cohort of 1,962 snoring hypertensive patients with hyperhomocysteinemia was divided into training (70%) and validation (30%) sets.
- Multivariate Cox regression identified predictors (age, waist-height ratio, smoking, LDL cholesterol).
- A nomogram was constructed and internally validated using bootstrap resampling and AUC analysis.
Main Results:
- The nomogram incorporated age, waist-height ratio, smoking, and LDL cholesterol.
- Area Under the Curve (AUC) values were 0.735 (training) and 0.646 (validation) at 80 months.
- Calibration plots indicated acceptable consistency between predicted and observed CHD survival.
Conclusions:
- A validated nomogram effectively predicts CHD risk in snoring hypertensive patients with elevated homocysteine.
- The nomogram serves as a practical clinical tool for early identification of high-risk individuals.
- Scores over 151 points indicate high CHD risk in this specific patient group.
Abstract:
Hypertensive patients with snoring and elevated plasma homocysteine levels are common. When these factors are combined, the risk of coronary heart disease (CHD) is high. Herein, we developed and validated an easy-to-use nomogram to predict high-risk CHD in snoring hypertensive patients with elevated plasma homocysteine.Snoring patients (n = 1,962) with hyperhomocysteinemia and hypertension were divided into training (n = 1,373, 70%) and validation (n = 589, 30%) sets. We extracted CHD predictors using multivariate Cox regression analysis, then constructed a nomogram model. Internal validation using 1,000 bootstrap resampling was performed to assess the consistency and discrimination of the predictive model using the area under the receiver operating characteristic curve (AUC) and calibration plots.We constructed a nomogram model with the extracted predictors, including age, waist-height ratio, smoking, and low-density lipoprotein cholesterol levels. The AUCs of the training and validation cohorts at 80 months were 0.735 (95% CI: 0.678-0.792) and 0.646 (95% CI: 0.547-0.746), respectively. The consistency between the observed CHD survival and the probability of CHD survival in the training and validation sets was acceptable based on the calibration plots. A total of more than 151 points in the nomogram can be used in the identification of high-risk patients for CHD among snoring hypertensive patients with elevated plasma homocysteine.We developed a CHD risk prediction model for snoring hypertension patients with hyperhomocysteinemia. Our findings provide a useful clinical tool for the rapid identification of high-risk CHD at an early stage.
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