1
|
Fan ZX, Wang CB, Fang LB, Ma L, Niu TT, Wang ZY, Lu JF, Yuan BY, Liu GZ. Risk factors and a Bayesian network model to predict ischemic stroke in patients with dilated cardiomyopathy. Front Neurosci 2022; 16:1043922. [PMID: 36440270 PMCID: PMC9683474 DOI: 10.3389/fnins.2022.1043922] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Accepted: 10/25/2022] [Indexed: 04/03/2024] Open
Abstract
OBJECTIVE This study aimed to identify risk factors and create a predictive model for ischemic stroke (IS) in patients with dilated cardiomyopathy (DCM) using the Bayesian network (BN) approach. MATERIALS AND METHODS We collected clinical data of 634 patients with DCM treated at three referral management centers in Beijing between 2016 and 2021, including 127 with and 507 without IS. The patients were randomly divided into training (441 cases) and test (193 cases) sets at a ratio of 7:3. A BN model was established using the Tabu search algorithm with the training set data and verified with the test set data. The BN and logistic regression models were compared using the area under the receiver operating characteristic curve (AUC). RESULTS Multivariate logistic regression analysis showed that hypertension, hyperlipidemia, atrial fibrillation/flutter, estimated glomerular filtration rate (eGFR), and intracardiac thrombosis were associated with IS. The BN model found that hyperlipidemia, atrial fibrillation (AF) or atrial flutter, eGFR, and intracardiac thrombosis were closely associated with IS. Compared to the logistic regression model, the BN model for IS performed better or equally well in the training and test sets, with respective accuracies of 83.7 and 85.5%, AUC of 0.763 [95% confidence interval (CI), 0.708-0.818] and 0.822 (95% CI, 0.748-0.896), sensitivities of 20.2 and 44.2%, and specificities of 98.3 and 97.3%. CONCLUSION Hypertension, hyperlipidemia, AF or atrial flutter, low eGFR, and intracardiac thrombosis were good predictors of IS in patients with DCM. The BN model was superior to the traditional logistic regression model in predicting IS in patients with DCM and is, therefore, more suitable for early IS detection and diagnosis, and could help prevent the occurrence and recurrence of IS in this patient cohort.
Collapse
Affiliation(s)
- Ze-Xin Fan
- Department of Neurology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Chao-Bin Wang
- Department of Neurology, Beijing Fangshan District Liangxiang Hospital, Beijing, China
| | - Li-Bo Fang
- Department of Neurology, Beijing Fuxing Hospital, Capital Medical University, Beijing, China
| | - Lin Ma
- Department of Neurology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Tian-Tong Niu
- Department of Neurology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Ze-Yi Wang
- Department of Neurology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Jian-Feng Lu
- Department of Neurology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Bo-Yi Yuan
- Department of Neurology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Guang-Zhi Liu
- Department of Neurology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| |
Collapse
|
2
|
Deng Y, Chen Z, Hu L, Xu Z, Hu J, Ma J, Yu J, Hu J, Li J, Xiong Q, Hong K. Decreased eGFR Is Associated With Ischemic Stroke in Patients With Dilated Cardiomyopathy. Clin Appl Thromb Hemost 2020; 25:1076029619866909. [PMID: 31373212 PMCID: PMC6829634 DOI: 10.1177/1076029619866909] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
Dilated cardiomyopathy (DCM) is increasingly indicated as a cause of cardioembolic
syndrome, in particular, cardioembolic ischemia stroke. However, the potential risk
factors for stroke among DCM patients remain under investigated. DCM patients hospitalized
from June 2011 to June 2016 were included. The cases were defined as the group of DCM
patients with stroke compared with those without stroke. Clinical characteristic data were
collected and compared between the two groups including demographic data, complicated
diseases, echocardiography index, and laboratory parameters and estimated glomerular
filtration rate (eGFR). A multivariate logistic regression analysis model adjusted by sex
and age was used to explore the related risk factors for stroke in DCM patients. A total
of 779 hospitalized patients with DCM were included. Of these, 55 (7.1%) had experienced a
stroke. Significantly lower eGFR levels (68.03 ± 26.22 vs 79.88 ± 24.25 mL/min/1.73
m2, P = .001) and larger left atrial diameters (45.32 ± 7.79
vs 43.25 ± 7.11 mm, P = .04) were found in the group of patients having
DCM with stroke compared to those without stroke. When the eGFR was categorized as eGFR
>60, 30<eGFR≤ 60 and eGFR ≤ 30, there were more patients with 30<eGFR≤ 60 (30.9%
vs 17.7%) and eGFR≤ 30 (9.1% vs 3.3%) in the ischemic stroke group (P =
0.003). A multivariate logistic regression analysis model adjusted by sex and age showed
that 30 <eGFR≤60 (odds ratio [OR]: 2.07, 95% confidence interval [CI]: [1.05-4.07],
P = .035) and eGFR≤30 (OR: 4.04, 95% CI: [1.41-11.62],
P = .009) were statistically associated with ischemic stroke in
patients with DCM. It is concluded that decreased eGFR is significantly associated with an
increased risk of ischemic stroke in patients with DCM.
Collapse
Affiliation(s)
- Yuqing Deng
- 1 Department of Cardiovascular Medicine, the second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, People's Republic of China.,2 Department of Cardiovascular Medicine, the third Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, People's Republic of China
| | - Zhiqing Chen
- 1 Department of Cardiovascular Medicine, the second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, People's Republic of China
| | - Lili Hu
- 1 Department of Cardiovascular Medicine, the second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, People's Republic of China.,3 Nephrology Department, the second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, People's Republic of China
| | - Zhenyan Xu
- 1 Department of Cardiovascular Medicine, the second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, People's Republic of China.,4 Jiangxi Key Laboratory of Molecular Medicine, Nanchang, Jiangxi, People's Republic of China
| | - Jinzhu Hu
- 1 Department of Cardiovascular Medicine, the second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, People's Republic of China
| | - Jianyong Ma
- 1 Department of Cardiovascular Medicine, the second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, People's Republic of China
| | - Jianhua Yu
- 1 Department of Cardiovascular Medicine, the second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, People's Republic of China
| | - Jianxin Hu
- 1 Department of Cardiovascular Medicine, the second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, People's Republic of China
| | - Juxiang Li
- 1 Department of Cardiovascular Medicine, the second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, People's Republic of China
| | - Qinmei Xiong
- 1 Department of Cardiovascular Medicine, the second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, People's Republic of China
| | - Kui Hong
- 1 Department of Cardiovascular Medicine, the second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, People's Republic of China.,4 Jiangxi Key Laboratory of Molecular Medicine, Nanchang, Jiangxi, People's Republic of China
| |
Collapse
|