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Published on: January 28, 2020
Exploring the predictive values of CRP and lymphocytes in coronary artery disease based on a machine learning and
Yuan Liu1,2, Xin Yuan1,2, Yu-Chan He1,2
1Department of Cardiology, Liuzhou People's Hospital, Affiliated of Guangxi Medical University, Liuzhou, Guangxi, China.
Insights
Leukocyte subsets and C-reactive protein (CRP) predict coronary artery disease (CAD). High lymphocyte counts and low CRP levels reduce major adverse cardiovascular events, while high CRP with low lymphocytes indicate a poor prognosis.
Area of Science:
- Cardiovascular Medicine
- Immunology
- Genetics
Background:
- Coronary artery disease (CAD) remains a leading cause of mortality worldwide.
- Identifying reliable biomarkers for CAD risk prediction is crucial for effective prevention and management.
- Leukocyte subsets and C-reactive protein (CRP) are implicated in inflammatory processes relevant to atherosclerosis.
Purpose of the Study:
- To investigate the predictive value of leukocyte subsets and C-reactive protein (CRP) in coronary artery disease (CAD).
- To establish the causal relationship between specific leukocyte subsets, CRP, and CAD risk.
- To evaluate the combined diagnostic and prognostic utility of CRP and lymphocyte levels in CAD patients.
Main Methods:
- A Mendelian randomization (MR) analysis was performed using data from 46,664 patients undergoing coronary angiography.
- Propensity score matching (PSM), logistic regression, LASSO regression, and random forest (RF) algorithms were employed for risk factor assessment.
- Receiver operating characteristic (ROC) curves evaluated model sensitivity and specificity, complemented by 36-month survival analysis.
Main Results:
- Basophil count, CRP levels, and lymphocyte count were identified as significant risk factors for CAD via inverse variance weight (IVW) analysis.
- LASSO, logistic regression, and RF analyses consistently identified CRP and lymphocyte counts as CAD risk factors, both before and after PSM.
- The combination of lymphocyte and CRP levels demonstrated a high diagnostic value (0.85) post-PSM.
- Survival analysis indicated that high lymphocyte counts and low CRP levels were associated with a decreased risk of Major Adverse Cardiovascular Events (MACE) (P < 0.001).
Conclusions:
- A causal relationship exists between lymphocytes, CRP, and CAD.
- The combined assessment of CRP and lymphocyte levels provides significant diagnostic value for CAD.
- High CRP levels coupled with low lymphocyte counts are associated with a poorer prognosis in CAD patients.
Purpose:
To investigate the predictive value of leukocyte subsets and C-reactive protein (CRP) in coronary artery disease (CAD).
Methods:
We conducted a Mendelian randomization analysis (MR) on leukocyte subsets, C-reactive protein (CRP) and CAD, incorporating data from 68,624 patients who underwent coronary angiography from 2010 to 2022. After initial screening, clinical data from 46,664 patients were analyzed. Techniques employed included propensity score matching (PSM), logistic regression, lasso regression, and random forest algorithms (RF). Risk factors were assessed, and the sensitivity and specificity of the models were evaluated using receiver operating characteristic (ROC) curves. Additionally, survival analysis was conducted based on a 36-month follow-up period.
Results:
The inverse variance weight (IVW) analysis showed that basophil count (OR 0.92, 95% CI: 0.84-1.00, P = 0.048), CRP levels (OR 0.87, 95% CI: 0.73-1.00, P = 0.040), and lymphocyte count (OR 1.10, 95% CI: 1.04-1.16, P = 0.001) are significant risk factors for CAD. Using LASSO regression, logistic regression, and RF analysis, both CRP and lymphocyte counts were consistently identified as risk factors for CAD, prior to and following PSM. The ROC curve analysis indicated that the combination of lymphocyte and CRP levels after PSM achieves a higher diagnostic value (0.85). Survival analysis revealed that high lymphocyte counts and low CRP levels are associated with a decreased risk of Major Adverse Cardiovascular Events (MACE) (P < 0.001). Conversely, a higher CRP level combined with lymphocyte counts correlates with a poorer prognosis.
Conclusion:
There is a causal relationship between lymphocytes, CRP and CAD. The combined assessment of CRP and lymphocytes offers diagnostic value for CAD. Furthermore, high CRP levels coupled with low lymphocyte counts are associated with a poor prognosis.
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