A study on predicting the risk of coronary artery disease in OSAHS patients based on a four-variable screening tool potential predictive model and its correlation with the severity of coronary atherosclerosis

ObjectiveThis study aims to evaluate the potential association between the four-variable screening tool (the 4 V) potential predictive model in predicting coronary artery disease (CAD) risk in patients with obstructive sleep apnea-hypopnea syndrome (OSAHS) and its correlation with the severity of co...

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Main Authors: Yanli Yao, Yu Li, Yulan Chen, Xuan Qiu, Gulimire Aimaiti, Ayiguzaili Maimaitimin
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-06-01
Series:Frontiers in Cardiovascular Medicine
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Online Access:https://www.frontiersin.org/articles/10.3389/fcvm.2025.1602492/full
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author Yanli Yao
Yu Li
Yulan Chen
Xuan Qiu
Gulimire Aimaiti
Ayiguzaili Maimaitimin
author_facet Yanli Yao
Yu Li
Yulan Chen
Xuan Qiu
Gulimire Aimaiti
Ayiguzaili Maimaitimin
author_sort Yanli Yao
collection DOAJ
description ObjectiveThis study aims to evaluate the potential association between the four-variable screening tool (the 4 V) potential predictive model in predicting coronary artery disease (CAD) risk in patients with obstructive sleep apnea-hypopnea syndrome (OSAHS) and its correlation with the severity of coronary atherosclerosis, as measured by the Gensini scoring system.Methods1197 OSAHS patients with suspected CAD who were hospitalized in the First Affiliated Hospital of Xinjiang Medical University between March 2020 and February 2024 were selected. The patients were submitted to coronary angiography or Coronary Computed Tomography Angiography (CCTA) examination to confirm the diagnosis. There were 423 cases in the OSAHS plus CAD group and 774 cases in the OSAHS group. LASSO regression analysis was carried out for screening potential influencing factors. Propensity score matching (PSM) was used to balance covariables between groups, and 293 cases were included per group in a 1:1 ratio. Univariable and multivariable logistic regression analyses were employed to evaluate parameters independently associated with CAD and construct a nomogram model.Receiver operating characteristic (ROC) curve analysis, Hosmer-Lemeshow test, calibration curve and decision curve (DCA) analyses were employed to assess its predictive value in CAD. A random forest machine learning algorithm was used to evaluate the importance of each risk factor. Pearson's or Spearman's correlation coefficients were employed to assess the strengths of associations among all variables and between predictors and Gensini scores, reflected in heat maps and chord diagrams, respectively.ResultsLASSO-logistic regression analysis revealed age (OR = 1.07, 95% CI: 1.05–1.1, P < 0.001), hypertension (OR = 1.29, 95% CI: 1.16–1.44, P < 0.001), AHI (OR = 1.02, 95% CI: 1.01–1.03, P = 0.007), and the 4 V (OR = 1.84, 95% CI: 1.21–2.79, P = 0.004) were independently associated with OSAHS plus CAD. The analysis of the ROC curve revealed that the combined utilization of the aforementioned predictors significantly enhances the potential predictive capability for patients with OSAHS developing CAD. The Hosmer-Lemeshow test, calibration curve, and DCA results indicate that potential predictive model based on the 4 V possesses significant clinical applicability in predicting OSAHS in conjunction with CAD. A comprehensive analysis utilizing the random forest machine learning algorithm demonstrated that the AHI exhibits the highest predictive value. Furthermore, the model's performance, as evaluated through out-of-bag error assessment, suggests robust efficacy. The correlation analysis results showed that the scores of the four-variable screening tool were positively correlated with the Gensini scores.ConclusionAge, hypertension, AHI, and the four-variable screening tool are independent risk factors for CAD in patients with OSAHS. The potential predictive model based on the 4 V is closely related to the prediction of CAD and its correlation with the severity of coronary atherosclerosis.
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spelling doaj-art-455a25ebd6f74de9bfa92bec50c16eaf2025-08-20T02:35:34ZengFrontiers Media S.A.Frontiers in Cardiovascular Medicine2297-055X2025-06-011210.3389/fcvm.2025.16024921602492A study on predicting the risk of coronary artery disease in OSAHS patients based on a four-variable screening tool potential predictive model and its correlation with the severity of coronary atherosclerosisYanli Yao0Yu Li1Yulan Chen2Xuan Qiu3Gulimire Aimaiti4Ayiguzaili Maimaitimin5Department of Hypertension, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, ChinaSecond Department of Comprehensive Internal Medicine, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, ChinaDepartment of Hypertension, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, ChinaDepartment of Hypertension, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, ChinaDepartment of Hypertension, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, ChinaDepartment of Hypertension, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, ChinaObjectiveThis study aims to evaluate the potential association between the four-variable screening tool (the 4 V) potential predictive model in predicting coronary artery disease (CAD) risk in patients with obstructive sleep apnea-hypopnea syndrome (OSAHS) and its correlation with the severity of coronary atherosclerosis, as measured by the Gensini scoring system.Methods1197 OSAHS patients with suspected CAD who were hospitalized in the First Affiliated Hospital of Xinjiang Medical University between March 2020 and February 2024 were selected. The patients were submitted to coronary angiography or Coronary Computed Tomography Angiography (CCTA) examination to confirm the diagnosis. There were 423 cases in the OSAHS plus CAD group and 774 cases in the OSAHS group. LASSO regression analysis was carried out for screening potential influencing factors. Propensity score matching (PSM) was used to balance covariables between groups, and 293 cases were included per group in a 1:1 ratio. Univariable and multivariable logistic regression analyses were employed to evaluate parameters independently associated with CAD and construct a nomogram model.Receiver operating characteristic (ROC) curve analysis, Hosmer-Lemeshow test, calibration curve and decision curve (DCA) analyses were employed to assess its predictive value in CAD. A random forest machine learning algorithm was used to evaluate the importance of each risk factor. Pearson's or Spearman's correlation coefficients were employed to assess the strengths of associations among all variables and between predictors and Gensini scores, reflected in heat maps and chord diagrams, respectively.ResultsLASSO-logistic regression analysis revealed age (OR = 1.07, 95% CI: 1.05–1.1, P < 0.001), hypertension (OR = 1.29, 95% CI: 1.16–1.44, P < 0.001), AHI (OR = 1.02, 95% CI: 1.01–1.03, P = 0.007), and the 4 V (OR = 1.84, 95% CI: 1.21–2.79, P = 0.004) were independently associated with OSAHS plus CAD. The analysis of the ROC curve revealed that the combined utilization of the aforementioned predictors significantly enhances the potential predictive capability for patients with OSAHS developing CAD. The Hosmer-Lemeshow test, calibration curve, and DCA results indicate that potential predictive model based on the 4 V possesses significant clinical applicability in predicting OSAHS in conjunction with CAD. A comprehensive analysis utilizing the random forest machine learning algorithm demonstrated that the AHI exhibits the highest predictive value. Furthermore, the model's performance, as evaluated through out-of-bag error assessment, suggests robust efficacy. The correlation analysis results showed that the scores of the four-variable screening tool were positively correlated with the Gensini scores.ConclusionAge, hypertension, AHI, and the four-variable screening tool are independent risk factors for CAD in patients with OSAHS. The potential predictive model based on the 4 V is closely related to the prediction of CAD and its correlation with the severity of coronary atherosclerosis.https://www.frontiersin.org/articles/10.3389/fcvm.2025.1602492/fullfour-variable screening toolobstructive sleep apnea hypopnea syndromecoronary artery diseasepredictionassociation study
spellingShingle Yanli Yao
Yu Li
Yulan Chen
Xuan Qiu
Gulimire Aimaiti
Ayiguzaili Maimaitimin
A study on predicting the risk of coronary artery disease in OSAHS patients based on a four-variable screening tool potential predictive model and its correlation with the severity of coronary atherosclerosis
Frontiers in Cardiovascular Medicine
four-variable screening tool
obstructive sleep apnea hypopnea syndrome
coronary artery disease
prediction
association study
title A study on predicting the risk of coronary artery disease in OSAHS patients based on a four-variable screening tool potential predictive model and its correlation with the severity of coronary atherosclerosis
title_full A study on predicting the risk of coronary artery disease in OSAHS patients based on a four-variable screening tool potential predictive model and its correlation with the severity of coronary atherosclerosis
title_fullStr A study on predicting the risk of coronary artery disease in OSAHS patients based on a four-variable screening tool potential predictive model and its correlation with the severity of coronary atherosclerosis
title_full_unstemmed A study on predicting the risk of coronary artery disease in OSAHS patients based on a four-variable screening tool potential predictive model and its correlation with the severity of coronary atherosclerosis
title_short A study on predicting the risk of coronary artery disease in OSAHS patients based on a four-variable screening tool potential predictive model and its correlation with the severity of coronary atherosclerosis
title_sort study on predicting the risk of coronary artery disease in osahs patients based on a four variable screening tool potential predictive model and its correlation with the severity of coronary atherosclerosis
topic four-variable screening tool
obstructive sleep apnea hypopnea syndrome
coronary artery disease
prediction
association study
url https://www.frontiersin.org/articles/10.3389/fcvm.2025.1602492/full
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