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Simonetto, C. ; Heier, M. ; Peters, A. ; Kaiser, J.C. ; Rospleszcz, S.

From atherosclerosis to myocardial infarction - a process-oriented model investigating the role of risk factors.

Am. J. Epidemiol. 191, 1766–1775 (2022)
Publ. Version/Full Text Postprint Research data DOI PMC
Open Access Gold (Paid Option)
Creative Commons Lizenzvertrag
Mathematical models are able to reflect biological processes and to capture epidemiological data. Thus, they may help elucidating roles of risk factors in disease progression. We propose to account for smoking, hypertension and dyslipidemia in a previously published process-oriented model that de- scribes the development of atherosclerotic lesions resulting in myocardial infarction (MI). The model is sex-specific and incorporates individual heterogeneity. It was applied to population-based individual risk factors and MI rates (KORA study) together with subclinical atherosclerotic le-sion data (PDAY Study). Different model variants were evaluated testing the association of risk factors with different disease processes. Best fits were obtained for smoking affecting a late stage disease process, suggesting a thrombo-genic role. Hypertension was mainly related to complicated, vulnerable lesions. Dyslipidemia was con-sistent with increasing the number of initial lesions. By accounting for heterogeneity, individual hazard ratios differ from the population average. The mean individual hazard ratio for smoking was twice the population based hazard ratio for men, and even more for women. Atherosclerotic lesion progression and MI incidence data can be related in a mathematical model to illuminate how risk factors affect different phases of this pathological process.
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Publication type Article: Journal article
Document type Scientific Article
Corresponding Author
Keywords Atherosclerosis ; Biological Models ; Cardiovascular Risk Factors ; Computer Simulation ; Myocardial Infarction ; Survival Analysis; KORA, Herz-Kreislauf, LMU, DZHK
ISSN (print) / ISBN 0002-9262
e-ISSN 1476-6256
Journal American Journal of Epidemiology
Quellenangaben Volume: 191, Issue: 10, Pages: 1766–1775 Article Number: , Supplement: ,
Publisher Oxford University Press
Non-patent literature Publications
Reviewing status Peer reviewed
Institute(s) Institute of Epidemiology II (EPI2)
Institute of Radiation Medicine (IRM)
Grants MEDIRAD