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Browsing by Author "Lin, Fay Y."

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  • Risk factors based vessel-specific prediction for stages of coronary artery disease using Bayesian quantile regression machine learning method: results from the PARADIGM registry
    Publication . Park, Hyung Bok; Lee, Jina; Hong, Yongtaek; Byungchang, So; Kim, Wonse; Lee, Byoung K.; Lin, Fay Y.; Hadamitzky, Martin; Kim, Yong Jin; Conte, Edoardo; Andreini, Daniele; Pontone, Gianluca; Budoff, Matthew J.; Gottlieb, Ilan; Chun, Eun Ju; Cademartiri, Filippo; Maffei, Erica; Marques, Hugo; Gonçalves, Pedro de A.; Leipsic, Jonathon A.; Shin, Sanghoon; Choi, Jung H.; Virmani, Renu; Samady, Habib; Chinnaiyan, Kavitha; Stone, Peter H.; Berman, Daniel S.; Narula, Jagat; Shaw, Leslee J.; Bax, Jeroen J.; Min, James K.; Kook, Woong; Chang, Hyuk Jae
    Background and Hypothesis: The recently introduced Bayesian quantile regression (BQR) machine-learning method enables comprehensive analyzing the relationship among complex clinical variables. We analyzed the relationship between multiple cardiovascular (CV) risk factors and different stages of coronary artery disease (CAD) using the BQR model in a vessel-specific manner. Methods: From the data of 1,463 patients obtained from the PARADIGM (NCT02803411) registry, we analyzed the lumen diameter stenosis (DS) of the three vessels: left anterior descending (LAD), left circumflex (LCx), and right coronary artery (RCA). Two models for predicting DS and DS changes were developed. Baseline CV risk factors, symptoms, and laboratory test results were used as the inputs. The conditional 10%, 25%, 50%, 75%, and 90% quantile functions of the maximum DS and DS change of the three vessels were estimated using the BQR model. Results: The 90th percentiles of the DS of the three vessels and their maximum DS change were 41%–50% and 5.6%–7.3%, respectively. Typical anginal symptoms were associated with the highest quantile (90%) of DS in the LAD; diabetes with higher quantiles (75% and 90%) of DS in the LCx; dyslipidemia with the highest quantile (90%) of DS in the RCA; and shortness of breath showed some association with the LCx and RCA. Interestingly, High-density lipoprotein cholesterol showed a dynamic association along DS change in the per-patient analysis. Conclusions: This study demonstrates the clinical utility of the BQR model for evaluating the comprehensive relationship between risk factors and baseline-grade CAD and its progression.
    2023-03Journal article Open access Show more
  • Sex and age-specific interactions of coronary atherosclerotic plaque onset and prognosis from coronary computed tomography
    Publication . Rosendael, Sophie E. Van; Bax, A. Maxim; Lin, Fay Y.; Achenbach, Stephan; Andreini, Daniele; Budoff, Matthew J.; Cademartiri, Filippo; Callister, Tracy Q.; Chinnaiyan, Kavitha; Chow, Benjamin J. W.; Cury, Ricardo C.; DeLago, Augustin J.; Feuchtner, Gudrun; Hadamitzky, Martin; Hausleiter, Joerg; Kaufmann, Philipp A.; Kim, Yong Jin; Leipsic, Jonathon A.; Maffei, Erica; Marques, Hugo; Gonçalves, Pedro de Araújo; Pontone, Gianluca; Raff, Gilbert L.; Rubinshtein, Ronen; Villines, Todd C.; Chang, Hyuk Jae; Berman, Daniel S.; Min, James K.; Bax, Jeroen J.; Shaw, Leslee J.; Rosendael, Alexander R. Van
    Aims: The totality of atherosclerotic plaque derived from coronary computed tomography angiography (CCTA) emerges as a comprehensive measure to assess the intensity of medical treatment that patients need. This study examines the differences in age onset and prognostic significance of atherosclerotic plaque burden between sexes. Methods and results: From a large multi-center CCTA registry the Leiden CCTA score was calculated in 24 950 individuals. A total of 11 678 women (58.5 ± 12.4 years) and 13 272 men (55.6 ± 12.5 years) were followed for 3.7 years for major adverse cardiovascular events (MACE) (death or myocardial infarction). The age where the median risk score was above zero was 12 years higher in women vs. men (64-68 years vs. 52-56 years, respectively, P < 0.001). The Leiden CCTA risk score was independently associated with MACE: score 6-20: HR 2.29 (1.69-3.10); score > 20: HR 6.71 (4.36-10.32) in women, and score 6-20: HR 1.64 (1.29-2.08); score > 20: HR 2.38 (1.73-3.29) in men. The risk was significantly higher for women within the highest score group (adjusted P-interaction = 0.003). In pre-menopausal women, the risk score was equally predictive and comparable with men. In post-menopausal women, the prognostic value was higher for women [score 6-20: HR 2.21 (1.57-3.11); score > 20: HR 6.11 (3.84-9.70) in women; score 6-20: HR 1.57 (1.19-2.09); score > 20: HR 2.25 (1.58-3.22) in men], with a significant interaction for the highest risk group (adjusted P-interaction = 0.004). Conclusion: Women developed coronary atherosclerosis approximately 12 years later than men. Post-menopausal women within the highest atherosclerotic burden group were at significantly higher risk for MACE than their male counterparts, which may have implications for the medical treatment intensity.
    2023-09-01Journal article Open access Show more