Xiaochun Duan, Mengdi Zhang, Xiaodong Sun, Yang Lin, Wenxing Peng
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A LASSO-derived model for the prediction of nonattainment of target LDL-C reduction with PCSK9 inhibitors in patients with atherosclerotic cardiovascular disease.
Background: Proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors have demonstrated significant efficacy in lowering low-density lipoprotein cholesterol (LDL-C) levels in patients with atherosclerotic cardiovascular disease (ASCVD), but some fail to achieve the target levels. This study aimed to explore the potential risk factors associated with this nonattainment of target LDL-C reduction (NTR-LDLC) and develop a prediction model.
Methods: The population was randomly divided into derivation and verification subsets in a 7:3 ratio. Utilizing the Least Absolute Shrinkage and Selection Operator (LASSO) regression, we filtered the variables within the derivation set. Subsequently, we assessed the model's predictive accuracy for the NTR-LDLC in both subsets through the application of decision curve analysis (DCA) and the plotting of receiver operating characteristic (ROC) curves.
Results: The study enrolled 748 patients, with 115 individuals experiencing NTR-LDLC. Using LASSO regression, five significant predictive factors associated with NTR-LDLC were identified: statin therapy, diastolic blood pressure (DBP), alanine aminotransferase (ALT), total cholesterol (TC), and LDL-C. Based on these results, a nomogram prediction model was constructed and validated, showing predictive accuracy with the area under the ROC curve (AUC) of 0.718 (95% confidence interval [CI]: 0.657 - 0.779) and 0.703 (95% CI: 0.605 - 0.801) for the derivation and validation sets, respectively.
Conclusions: This study presents a LASSO-derived predictive model that can be used to predict the risk of NTR-LDLC with PCSK9 inhibitors in patients with ASCVD.
期刊介绍：
Lipids in Health and Disease is an open access, peer-reviewed, journal that publishes articles on all aspects of lipids: their biochemistry, pharmacology, toxicology, role in health and disease, and the synthesis of new lipid compounds.
Lipids in Health and Disease is aimed at all scientists, health professionals and physicians interested in the area of lipids. Lipids are defined here in their broadest sense, to include: cholesterol, essential fatty acids, saturated fatty acids, phospholipids, inositol lipids, second messenger lipids, enzymes and synthetic machinery that is involved in the metabolism of various lipids in the cells and tissues, and also various aspects of lipid transport, etc. In addition, the journal also publishes research that investigates and defines the role of lipids in various physiological processes, pathology and disease. In particular, the journal aims to bridge the gap between the bench and the clinic by publishing articles that are particularly relevant to human diseases and the role of lipids in the management of various diseases.
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