scholarly journals Develop and validate a nomogram for predicting stroke inrheumatoidarthritis patients by electronic medical record data in northern China

2020 ◽  
Author(s):  
Fangran Xin ◽  
Bowen Yang ◽  
Lingyu Fu ◽  
Haina Liu ◽  
Tingting Wei ◽  
...  

Abstract Background: to develop and validate a serum lipid and inflammatory marker model based on the nomogram for the prediction of stroke risk in rheumatoid arthritis patients.Methods: This study was conducted among 313 rheumatoid arthritis with stroke patients and 1827 rheumatoid arthritis patients divided into develop and validation cohorts from the First Affiliated Hospital of China Medical University during January 2011 to December 2018. Logistic regression analysis was used to create a nomogram of predictive model of stroke risk in rheumatoid arthritis patients, after comparing with other machine algorithms. The performance of the nomogram was evaluated by discrimination, calibration and decision curve analysis, also compared with the Framingham Risk Score in predicting stroke in rheumatoid arthritis patients.Results: the nomogram was performed by logistic regression algorithm, and predictors of which included the stratifications of sex, age, systolic blood pressure, C-reactive protein, erythrocyte sedimentation rate, total cholesterol, low density lipoprotein cholesterol and the distribution of being accompanied with hy-med, diabetes, atrial fibrillation and coronary heart disease history, which exhibited a well goodness fit and a good agreement. The analysis with area under the curve, the net reclassification index, the integrated discrimination improvement and clinical use, suggested that this is an easy-to-use nomogram compared with the Framingham Risk Score.Conclusion: This study presents a risk nomogram that incorporates the traditional risk factors, serum lipids and inflammatory markers which can be used to predict stroke in rheumatoid arthritis patients.

2021 ◽  
Vol 73 (1) ◽  
Author(s):  
Gökhan Ceyhun

Abstract Background In this study considering the relationship between serum endocan and CHA2DS2-VASc score, we assumed that endocan level could be a new biomarker for stroke risk in patients with paroxysmal atrial fibrillation (PAF). It was examined that endocan could be an alternative to determine the risk of stroke and anticoagulation strategy in patients with PAF. The CHA2DS2-VASc scores were calculated for 192 patients with PAF, and their serum endocan levels were measured. The patients were divided into two groups as those with low to moderate (0-1) and those with high (≥ 2) CHA2DS2-VASc scores, and the endocan levels were compared between these two groups. Results The serum endocan level was significantly higher in the high CHA2DS2-VASc score group (p < 0.001). In the multivariate logistic regression analysis, endocan, C-reactive protein, and low-density lipoprotein were found to be independent determinants of the CHA2DS2-VASc score. The predictive value of endocan was analyzed using the ROC curve analysis, which revealed that endocan predicted a high stroke risk (CHA2DS2-VASc ≥ 2) at 82.5% sensitivity and 71.2% specificity at the cutoff value of 1.342. Conclusion This study indicates that endocan is significantly associated with CHA2DS2-VASc score. We demonstrated that endocan could be a new biomarker for the prediction of a high stroke risk among patients diagnosed with PAF.


2022 ◽  
Vol 24 (1) ◽  
Author(s):  
Bing Wang ◽  
Hui Deng ◽  
Yao Hu ◽  
Ling Han ◽  
Qiong Huang ◽  
...  

Abstract Background Methotrexate (MTX) has a protective effect against cardiovascular diseases (CVD), but the mechanism is unclear. Objective To investigate the effect of MTX on lipid profiles and the difference between psoriasis without arthritis (PsO) and psoriatic arthritis (PsA). Methods In this prospective study, we recruited 288 psoriatic patients (136 PsA and 152 PsO) who completed 12 weeks of MTX treatment. Total cholesterol (TC), triglycerides (TG), lipoprotein A [LP(a)], high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein (LDL), apolipoprotein A1 (ApoA1), and ApoB were measured. Results Compared with sex- and age-matched healthy controls, psoriatic patients had significantly (p < 0.0001) higher levels of proatherogenic lipids and lower levels of anti-atherogenic lipids. PsA patients had a higher ApoB/ApoA1 ratio than PsO patients (p < 0.05). Stepwise regression analysis found a positive correlation between the inflammatory marker hCRP and the Psoriasis Area Severity Index (PASI), ApoB/ApoA1 ratio, BMI, and smoking. ApoB was positively associated with concomitant arthritis, diabetes, and hypertension. MTX decreased the levels of pro-atherogenic and anti-atherogenic lipids. However, a significant reduction of the ApoB/ApoA1 ratio by MTX was only observed in male patients. Conclusion PsA patients had a significantly higher percentage of concomitant disease than PsO. The decrease of MTX on CVD might be related with sex. Trial registration ChiCTR2000036192


2020 ◽  
Vol 51 (5) ◽  
pp. 529-539
Author(s):  
Tingting Zeng ◽  
Liming Tan ◽  
Yang Wu ◽  
Jianlin Yu

Abstract Background Early identification and disease monitoring are challenges facing rheumatologists in the management of rheumatoid arthritis (RA). Methods We utilized enzyme-linked immunosorbent assay (ELISA) to determine 14-3-3η and anticyclic citrullinated peptide antibody (anti-CCP) levels, with rheumatoid factor (RF) level detected by rate nephelometry. The diagnostic value of each index was determined via receiver operating characteristic (ROC) curve, and the association between 14-3-3η and osteoporosis was assessed using multiple logistic regression analysis. Results Serum levels of 14-3-3η were 3.26 ng per mL in patients with RA. These levels were helpful in identifying patients with the disease, with the area under the curve (AUC) being 0.879 and 0.853, respectively, from all healthy control individuals and patients with RA. Combining 14-3-3η with RF or anti-CCP increased the diagnostic rate. Logistic regression analysis identified 14-3-3η as an independent risk factor for RA-related osteoporosis (odds ratio [OR], 1.503; 95% confidence interval [CI], 1.116–2.025; P &lt;.01). Conclusions Serum 14-3-3η detection by itself or combined with other serum indices was helpful in differentiating patients with RA. Also, it was a promising biomarker for disease monitoring in RA.


2013 ◽  
Vol 40 (6) ◽  
pp. 798-808 ◽  
Author(s):  
Yune-Jung Park ◽  
Seung-Ah Yoo ◽  
Susanna Choi ◽  
Hee-Soo Yoo ◽  
Ho-Sung Yoon ◽  
...  

Objective.Dyslipidemia, a risk factor for cardiovascular diseases, is more prevalent in patients with rheumatoid arthritis (RA) than in the general population. We investigated whether single-nucleotide polymorphisms (SNP) modulating low-density lipoprotein (LDL) cholesterol affect susceptibility, severity, and progression of RA.Methods.We enrolled 302 patients with RA and 1636 healthy controls, and investigated the SNP modulating LDL cholesterol. Clinical characteristics of RA, serum adipocytokine concentrations, and radiographic severity were analyzed according to genotype score based on the number of unfavorable alleles. The influence of genotype score on radiographic progression was also investigated using multivariable logistic models.Results.We identified 3 SNP (rs688, rs693, and rs4420638) modulating LDL cholesterol in Koreans, which correlated well with LDL cholesterol levels in both patients with RA and controls. Among them, 2 SNP, rs688 and rs4420638, were more prevalent in patients with RA than in controls. In patients with RA carrying more unfavorable alleles (genotype score ≥ 3), disease activity measures, serum adipocytokine levels, and radiographic severity were all increased. The genotype score was an independent risk factor for radiographic progression of RA over 2 years, and its effect was greater than the influence of conventional risk factors.Conclusion.SNP modulating LDL cholesterol influence the risk, activity, and severity of RA. These results provide the first evidence that genetic mechanisms linked to dyslipidemia may directly contribute to the susceptibility and prognosis of RA, a representative of chronic inflammatory diseases, explaining the high incidence of dyslipidemia in RA.


2012 ◽  
Vol 39 (5) ◽  
pp. 946-948 ◽  
Author(s):  
ANDRONIKI BILI ◽  
STEPHANIE J. MORRIS ◽  
JENNIFER A. SARTORIUS ◽  
H. LES KIRCHNER ◽  
JANA L. ANTOHE ◽  
...  

Objective.To determine the association of use of tumor necrosis factor-α (TNF-α) inhibitors with differences in lipid levels in patients with rheumatoid arthritis (RA).Methods.We studied 807 patients with incident RA to compare differences in lipid levels in TNF-α inhibitor users versus nonusers, with adjustment for relevant covariables.Results.TNF-α inhibitor use was not associated with differences in levels of low-density lipoprotein (LDL), high-density lipoprotein (HDL), total cholesterol (TC), triglycerides, LDL:HDL, or TC:HDL compared to nonusers.Conclusion.Use of TNF-α inhibitor was not associated with differences in lipid levels in patients with RA.


2022 ◽  
Author(s):  
Jiahui Li ◽  
Haina Liu ◽  
Bingbing Dai ◽  
Zhijun Fan ◽  
Qiao Wang ◽  
...  

Abstract Objective Serum amyloid A4 (SAA4) is an apolipoprotein that is associated with high-density lipoprotein (HDL) in plasma. In this present investigation, we appraised the potential of SAA4 as a novel diagnostic biomarker for rheumatoid arthritis (RA) combined with other established RA biomarkers, including anticitrullinated protein antibody (anti-CCP), rheumatoid factor (RF),and C-reactive protein (CRP). Based on the correlative measures of the biomarkers, we developed a diagnostic model of RA by integrating serum levels of SAA4 with these clinical parameters. Methods A number of 316 patients were recruited in the current research. The serum levels of SAA4 were assessed by quantitative ELISA. The specificity and sensitivity of biomarkers were evaluated by using a receiver-operator curve (ROC) analysis to determine their diagnostic efficiency. Univariate and multivariate logistic regression analyses were used to screen and construct the diagnostic models for RA , consisting of diagnostic biomarkers and clinical data. A diagnostic nomogram was then generated based on logistic regression analysis results. Results The serum levels of SAA4 were considerably greatest in RA patients in comparison to other control subjects (P<0.001). Compared with anti-CCP, RF and CRP respectively, SAA4 had the highest specificity (88.60%) for diagnosing RA. The combination of SAA4 with anti-CCP could have the highest diagnostic accuracy when paired together, with highest sensitivity (91.14%) in parallel and highest specificity(98.10) in series. We successfully developed two diagnostic models: the combined model of SAA4 and anti-CCP (model A), and the combined model of SAA4, CRP, anti-CCP, RF and history of diabetes (model B). Both models showed a great area under the curve of ROC for either the training cohort or the validation cohort. The data indicated that the novel RA diagnostic models possessed an advantageous discrimination capacity and application potential. Conclusion Serum SAA4 has utility as a biomarker for RA’s diagnosis and can enhance the detection of RA when combined with anti-CCP.


2021 ◽  
Author(s):  
Bing Wang ◽  
Hui Deng ◽  
Yao Hu ◽  
Ling Han ◽  
Qiong Huang ◽  
...  

Abstract Background: Methotrexate (MTX) has a protective effect against cardiovascular diseases (CVD), but the mechanism is unclear.Objective: To investigate the effect of MTX on lipid profiles and the difference between psoriasis without arthritis (PsO) and psoriatic arthritis (PsA).Methods: In this prospective study, we recruited 288 psoriatic patients (136 PsA and 152 PsO) who completed 12 weeks of MTX treatment. Total cholesterol (TC), triglycerides (TG), lipoprotein A [LP(a)], high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein (LDL), apolipoprotein A1 (ApoA1), and ApoB were measured.Results: Compared with sex and age-matched healthy controls, psoriatic patients had significantly (p<0.0001) higher levels of proatherogenic lipids and lower levels of anti-atherogenic lipids. PsA patients had a higher ApoB/ApoA1 ratio than PsO patients(p<0.05). Stepwise regression analysis found a positive correlation between the inflammatory marker hCRP and the psoriasis area severiy index (PASI), ApoB/ApoA1 ratio, BMI, and smoking. ApoB was positively associated with concomitant arthritis, diabetes and hypertension. MTX decreased the levels of pro-atherogenic and anti-atherogenic lipids. However, a significant reduction of the ApoB/ApoA1 ratio by MTX was only observed in male patients.Conclusion: PsA patients had a significantly higher percentage of concomitant disease than PsO. The decrease of MTX on CVD might be related with sex.Trial Registration: ChiCTR2000036192


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