Lipoprotein Metabolism Indicators Improve Cardiovascular Risk Prediction

Daniël B van Schalkwijk, Albert A de Graaf, Evgeni Tsivtsivadze, Laurence D Parnell, Bianca J C van der Werff-van der Vat, Ben van Ommen, Jan van der Greef and José M Ordovás

PLOS ONE, 2014, vol. 9, issue 3, 1-7

Abstract: Background: Cardiovascular disease risk increases when lipoprotein metabolism is dysfunctional. We have developed a computational model able to derive indicators of lipoprotein production, lipolysis, and uptake processes from a single lipoprotein profile measurement. This is the first study to investigate whether lipoprotein metabolism indicators can improve cardiovascular risk prediction and therapy management. Methods and Results: We calculated lipoprotein metabolism indicators for 1981 subjects (145 cases, 1836 controls) from the Framingham Heart Study offspring cohort in which NMR lipoprotein profiles were measured. We applied a statistical learning algorithm using a support vector machine to select conventional risk factors and lipoprotein metabolism indicators that contributed to predicting risk for general cardiovascular disease. Risk prediction was quantified by the change in the Area-Under-the-ROC-Curve (ΔAUC) and by risk reclassification (Net Reclassification Improvement (NRI) and Integrated Discrimination Improvement (IDI)). Two VLDL lipoprotein metabolism indicators (VLDLE and VLDLH) improved cardiovascular risk prediction. We added these indicators to a multivariate model with the best performing conventional risk markers. Our method significantly improved both CVD prediction and risk reclassification. Conclusions: Two calculated VLDL metabolism indicators significantly improved cardiovascular risk prediction. These indicators may help to reduce prescription of unnecessary cholesterol-lowering medication, reducing costs and possible side-effects. For clinical application, further validation is required.

Date: 2014
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Persistent link: https://EconPapers.repec.org/RePEc:plo:pone00:0092840

DOI: 10.1371/journal.pone.0092840

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