Prediction of cardiovascular risk in patients with chronic obstructive pulmonary disease: a study of the National Health and Nutrition Examination Survey database

Abstract

Background Cardiovascular disease (CVD) is a common comorbidity associated with chronic obstructive pulmonary disease (COPD), but few studies have been conducted to identify CVD risk in COPD patients. This study was to develop a predictive model of CVD in COPD patients based on the National Health and Nutrition Examination Survey (NHANES) database. Methods A total of 3,226 COPD patients were retrieved from NHANES 2007–2012, dividing into the training (n = 2351) and testing (n = 895) sets. The prediction models were conducted using the multivariable logistic regression and random forest analyses, respectively. Receiver operating characteristic (ROC) curves, area under the curves (AUC) and internal validation were used to assess the predictive performance of models. Results The logistic regression model for predicting the risk of CVD was developed regarding age, gender, body mass index (BMI), high-density lipoprotein (HDL), glycosylated hemoglobin (HbA1c), family history of heart disease, and stayed overnight in the hospital due to illness last year, which the AUC of the internal validation was 0.741. According to the random forest analysis, the important variables-associated with CVD risk were screened including smoking (NNAL and cotinine), HbA1c, HDL, age, gender, diastolic blood pressure, poverty income ratio, BMI, systolic blood pressure, and sedentary activity per day. The AUC of the internal validation was 0.984, indicating the random forest model for predicting the CVD risk in COPD cases was superior to the logistic regression model. Conclusion The random forest model performed better predictive effectiveness for the cardiovascular risk among COPD patients, which may be useful for clinicians to guide the clinical practice.

Nomograms for Predicting Coexisting Cardiovascular Disease and Prognosis in Chronic Obstructive Pulmonary Disease: A Study Based on NHANES Data

“…While the C-index of our model for predicting CVD amounted to 0.747, the parameters included (gender, age, peripheral blood neutrophil, RDW, LDH, HbA1c) were easily obtained and the model was presented as a nomogram. Compared with the prediction model developed by Shi et al [ 42 ], the parameters we included in the model were more simplified, and the nomogram was presented in a more intuitive form, which can effectively help clinicians and patients to early identify COPD coexisting CVD. Yukiyo Sakamoto et al developed a nomogram to predict COPD in-hospital mortality based on variables including age, gender, BMI, disturbance of consciousness, severe dyspnea, history of mechanical ventilation, pneumonia, and comorbid asthma on admission, with a C-index of 0.775 [ 43 ].…”

“…Second, due to the lack of spirometry data in the NHANES database 2005–2006, the selection of our included study subjects relied on questionnaire data rather than GOLD diagnostic criteria for hospitalized COPD, which may be biased to some extent. However, in a previous study based on the NHANES database 2007–2012 comparing AUC between COPD determined by spirometry data and questionnaire data, there was little difference in AUC which demonstrated a difference between COPD patients identified by the two modalities was small [ 42 ]. Third, since there were no data on lung function, we could not assess the relationship between COPD severity with CVD and COPD mortality, and the established nomogram did not include the COPD stage.…”

Interaction between rheumatoid arthritis and mediterranean diet on the risk of cardiovascular disease for the middle aged and elderly from National Health and Nutrition Examination Survey (NHANES)

“…The diagnosis of RA was based on the self-reported information: “Has a doctor or other health professional ever told you that you had RA?”. The individuals would be diagnosed as having RA if the question were answered as “yes” [ 21 ].…”

The Relationship of Cholesterol Responses to Mitochondrial Dysfunction and Lung Inflammation in Chronic Obstructive Pulmonary Disease

“…COPD is the fourth leading cause of death in the US [ 2 ]. Cholesterol levels are an important prognostic marker of cardiovascular risk in patients with COPD [ 3 ]. Exposure to cigarette smoke is the primary environmental factor associated with the development of COPD.…”