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      Genotype-driven identification of a molecular network predictive of advanced coronary calcium in ClinSeq® and Framingham Heart Study cohorts

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          Abstract

          Background

          One goal of personalized medicine is leveraging the emerging tools of data science to guide medical decision-making. Achieving this using disparate data sources is most daunting for polygenic traits. To this end, we employed random forests (RFs) and neural networks (NNs) for predictive modeling of coronary artery calcium (CAC), which is an intermediate endo-phenotype of coronary artery disease (CAD).

          Methods

          Model inputs were derived from advanced cases in the ClinSeq®; discovery cohort (n=16) and the FHS replication cohort (n=36) from 89 th -99 th CAC score percentile range, and age-matched controls (ClinSeq®; n=16, FHS n=36) with no detectable CAC (all subjects were Caucasian males). These inputs included clinical variables and genotypes of 56 single nucleotide polymorphisms (SNPs) ranked highest in terms of their nominal correlation with the advanced CAC state in the discovery cohort. Predictive performance was assessed by computing the areas under receiver operating characteristic curves (ROC-AUC).

          Results

          RF models trained and tested with clinical variables generated ROC-AUC values of 0.69 and 0.61 in the discovery and replication cohorts, respectively. In contrast, in both cohorts, the set of SNPs derived from the discovery cohort were highly predictive (ROC-AUC ≥0.85) with no significant change in predictive performance upon integration of clinical and genotype variables. Using the 21 SNPs that produced optimal predictive performance in both cohorts, we developed NN models trained with ClinSeq®; data and tested with FHS data and obtained high predictive accuracy (ROC-AUC=0.80-0.85) with several topologies. Several CAD and “vascular aging" related biological processes were enriched in the network of genes constructed from the predictive SNPs.

          Conclusions

          We identified a molecular network predictive of advanced coronary calcium using genotype data from ClinSeq®; and FHS cohorts. Our results illustrate that machine learning tools, which utilize complex interactions between disease predictors intrinsic to the pathogenesis of polygenic disorders, hold promise for deriving predictive disease models and networks.

          Electronic supplementary material

          The online version of this article (doi:10.1186/s12918-017-0474-5) contains supplementary material, which is available to authorized users.

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          Most cited references68

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          Inflammation in atherosclerosis: from pathophysiology to practice.

          Until recently, most envisaged atherosclerosis as a bland arterial collection of cholesterol, complicated by smooth muscle cell accumulation. According to that concept, endothelial denuding injury led to platelet aggregation and release of platelet factors which would trigger the proliferation of smooth muscle cells in the arterial intima. These cells would then elaborate an extracellular matrix that would entrap lipoproteins, forming the nidus of the atherosclerotic plaque. Beyond the vascular smooth muscle cells long recognized in atherosclerotic lesions, subsequent investigations identified immune cells and mediators at work in atheromata, implicating inflammation in this disease. Multiple independent pathways of evidence now pinpoint inflammation as a key regulatory process that links multiple risk factors for atherosclerosis and its complications with altered arterial biology. Knowledge has burgeoned regarding the operation of both innate and adaptive arms of immunity in atherogenesis, their interplay, and the balance of stimulatory and inhibitory pathways that regulate their participation in atheroma formation and complication. This revolution in our thinking about the pathophysiology of atherosclerosis has now begun to provide clinical insight and practical tools that may aid patient management. This review provides an update of the role of inflammation in atherogenesis and highlights how translation of these advances in basic science promises to change clinical practice.
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            EDF Statistics for Goodness of Fit and Some Comparisons

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              Gender differences in coronary heart disease.

              Cardiovascular disease develops 7 to 10 years later in women than in men and is still the major cause of death in women. The risk of heart disease in women is often underestimated due to the misperception that females are 'protected' against cardiovascular disease. The under-recognition of heart disease and differences in clinical presentation in women lead to less aggressive treatment strategies and a lower representation of women in clinical trials. Furthermore, self-awareness in women and identification of their cardiovascular risk factors needs more attention, which should result in a better prevention of cardiovascular events. In this review we summarise the major issues that are important in the diagnosis and treatment of coronary heart disease in women. (Neth Heart J 2010;18:598-603.).
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                Author and article information

                Contributors
                cihan.oguz@nih.gov
                sensh@mail.nih.gov
                davisar@mail.nih.gov
                fuy2@nhlbi.nih.gov
                christopher.odonnell@va.gov
                Gary.Gibbons@nih.gov
                Journal
                BMC Syst Biol
                BMC Syst Biol
                BMC Systems Biology
                BioMed Central (London )
                1752-0509
                26 October 2017
                26 October 2017
                2017
                : 11
                : 99
                Affiliations
                [1 ]ISNI 0000 0001 2297 5165, GRID grid.94365.3d, Cardiovascular Disease Section, National Human Genome Research Institute, , National Institutes of Health, ; Bethesda, MD USA
                [2 ]ISNI 0000 0001 2297 5165, GRID grid.94365.3d, Office of Biostatistics Research, Division of Cardiovascular Sciences, National Heart, Lung and Blood Institute, , National Institutes of Health, ; Bethesda, MD USA
                [3 ]ISNI 0000 0004 0367 5222, GRID grid.475010.7, Framingham Heart Study, , Boston University School of Medicine, ; Boston, MA USA
                [4 ]Center for Population Genomics, MAVERIC, VA Healthcare System, Boston, MA USA
                [5 ]Cardiology Section Administration, VA Healthcare System, Boston, MA USA
                [6 ]Department of Cardiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA USA
                [7 ]ISNI 0000 0001 2297 5165, GRID grid.94365.3d, Office of the Director, National Heart, Lung and Blood Institute, , National Institutes of Health, ; Bethesda, MD USA
                Article
                474
                10.1186/s12918-017-0474-5
                5659034
                29073909
                a1baa1e1-2f6c-4d35-9439-fbfa402b4830
                © The Author(s) 2017

                Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 5 April 2017
                : 17 October 2017
                Funding
                Funded by: FundRef http://dx.doi.org/10.13039/100000051, National Human Genome Research Institute;
                Award ID: HG200393
                Award Recipient :
                Funded by: FundRef http://dx.doi.org/10.13039/100000002, National Institutes of Health;
                Award ID: HG200359 08
                Funded by: FundRef http://dx.doi.org/10.13039/100000002, National Institutes of Health;
                Award ID: HG200387 03
                Funded by: FundRef http://dx.doi.org/10.13039/100000050, National Heart, Lung, and Blood Institute;
                Award ID: N01-HC-25195
                Funded by: FundRef http://dx.doi.org/10.13039/100000050, National Heart, Lung, and Blood Institute;
                Award ID: N02-HL-64278
                Categories
                Research Article
                Custom metadata
                © The Author(s) 2017

                Quantitative & Systems biology
                coronary artery calcium,random forest,neural networks,case-control study,coronary heart disease,genotype data,systems biology

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