Personalized prediction of adverse heart and kidney events using baseline and longitudinal data from SPRINT and ACCORD

PloS One
Gal DinstagRon Shamir

Abstract

The 2017 guidelines of the American College of Cardiology and the American Heart Association propose substantial changes to hypertension management. The guidelines lower the blood pressure threshold defining hypertension and promote more aggressive treatments. Thus, more individuals are now classified as hypertensive and as a result, medication usage may become more extensive. An inevitable byproduct of greater medication use is higher incidence of adverse effects. Here, we examined these issues by developing models that predict both cardiovascular events and other adverse events based on the treatment chosen and other patient's data. We used data from the SPRINT trial to produce patient-specific predictions of the risks for adverse cardiovascular or kidney outcomes. Unlike prior models, we used both the baseline characteristics collected upon recruitment and the longitudinal data during the follow-up. Importantly, our cardiovascular predictor outperformed extant models on SPRINT participants, achieving AUC = 0.765, and was validated with good performance in an independent cohort of the ACCORD trial. Our study illustrates the importance of including longitudinal data for assessing personalized risk and provides means for recomm...Continue Reading

References

Mar 17, 2010·The New England Journal of Medicine·William C CushmanFaramarz Ismail-Beigi
Mar 1, 2011·Journal of Statistical Software·Noah SimonRob Tibshirani
Jun 9, 2016·The New England Journal of Medicine·Jackson T WrightDavid M Reboussin
Apr 27, 2017·The New England Journal of Medicine·Nancy S Burns, Pamela W Miller
Dec 16, 2017·JAMA : the Journal of the American Medical Association·John P A Ioannidis
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Methods Mentioned

BETA
pharmacotherapy

Software Mentioned

ACCORD
SPRINT
R

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Cardiovascular disease involves several different processes that contribute to the pathological mechanism, including hyperglycemia, inflammation, atherosclerosis, hypertension and more. Vasculature stability plays a critical role in the development of the disease. Discover the latest research on cardiovascular disease pathophysiology here.

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