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. 2024 Feb 22;14(1):4361.
doi: 10.1038/s41598-024-55141-2.

Unraveling atherosclerotic cardiovascular disease risk factors through conditional probability analysis with Bayesian networks: insights from the AZAR cohort study

Parya Esmaeili  1   2 , Neda Roshanravan  3 , Samad Ghaffari  3 , Naimeh Mesri Alamdari  4 , Mohammad Asghari-Jafarabadi  5   6   7   8
Affiliations

Unraveling atherosclerotic cardiovascular disease risk factors through conditional probability analysis with Bayesian networks: insights from the AZAR cohort study

Parya Esmaeili et al. Sci Rep. .

Abstract

This study aimed at modelling the underlying predictor of ASCVD through the Bayesian network (BN). Data for the AZAR Cohort Study, which evaluated 500 healthcare providers in Iran, was collected through examinations, and blood samples. Two BNs were used to explore a suitable causal model for analysing the underlying predictor of ASCVD; Bayesian search through an algorithmic approach and knowledge-based BNs. Results showed significant differences in ASCVD risk factors across background variables' levels. The diagnostic indices showed better performance for the knowledge-based BN (Area under ROC curve (AUC) = 0.78, Accuracy = 76.6, Sensitivity = 62.5, Negative predictive value (NPV) = 96.0, Negative Likelihood Ratio (LR-) = 0.48) compared to Bayesian search (AUC = 0.76, Accuracy = 72.4, Sensitivity = 17.5, NPV = 93.2, LR- = 0.83). In addition, we decided on knowledge-based BN because of the interpretability of the relationships. Based on this BN, being male (conditional probability = 63.7), age over 45 (36.3), overweight (51.5), Mets (23.8), diabetes (8.3), smoking (10.6), hypertension (12.1), high T-C (28.5), high LDL-C (23.9), FBS (12.1), and TG (25.9) levels were associated with higher ASCVD risk. Low and normal HDL-C levels also had higher ASCVD risk (35.3 and 37.4), while high HDL-C levels had lower risk (27.3). In conclusion, BN demonstrated that ASCVD was significantly associated with certain risk factors including being older and overweight male, having a history of Mets, diabetes, hypertension, having high levels of T-C, LDL-C, FBS, and TG, but Low and normal HDL-C and being a smoker. The study may provide valuable insights for developing effective prevention strategies for ASCVD in Iran.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Figure 1
Figure 1
BN structures and probabilities for ASCVD.
Figure 2
Figure 2
Receiver operating characteristics curves of the Bayesian Networks.
Figure 3
Figure 3
Model comparisons.
See this image and copyright information in PMC

References

    1. Ellulu MS, Patimah I, Khazaai H, Rahmat A, Abed Y, Ali F. Atherosclerotic cardiovascular disease: A review of initiators and protective factors. Inflammopharmacology. 2016;24:1–10. doi: 10.1007/s10787-015-0255-y. - DOI - PubMed
    1. Sanz J, Fayad ZA. Imaging of atherosclerotic cardiovascular disease. Nature. 2008;451(7181):953–957. doi: 10.1038/nature06803. - DOI - PubMed
    1. Gavrilenko AV, Nikolenko VN, Al-Yusef NN, Zharikova TS, Bulatova LR, Li Z. Correlation between morphological and biomechanical features and carotid atherosclerosis. Sci. Innov. Med. 2022;7(3):160–163. doi: 10.35693/2500-1388-2022-7-3-160-163. - DOI
    1. Soomro MK, Kumar J, Shah GF, Rahu QA, Tanwani BM, Rathi NL. Assessment of the cardiovascular medication adherence and its related factors in patients with coronary artery angioplasty at Pmc Hospital Nawabshah. J. Peoples Univ. Med. Health Sci. Nawabshah. 2020;10(4):18–21. doi: 10.35693/2500-1388-2022-7-3-160-163. - DOI
    1. Zardawi F, Gul S, Abdulkareem A, Sha A, Yates J. Association between periodontal disease and atherosclerotic cardiovascular diseases: Revisited. Front. Cardiovasc. Med. 2021;7:625579. doi: 10.3389/fcvm.2020.625579. - DOI - PMC - PubMed

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