ORIGINAL RESEARCH article
Front. Cardiovasc. Med.
Sec. Coronary Artery Disease
Volume 12 - 2025 | doi: 10.3389/fcvm.2025.1558012
This article is part of the Research TopicMechanisms and Management of Inflammation-driven Cardiovascular Risk: from Obesity and Diabetes to Autoimmunity and CancerView all 10 articles
Analysis of Risk Factors and the Predictive Value of a Nomogram Model for Coronary Heart Disease in Patients with Rheumatoid Arthritis
Provisionally accepted
- Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Third Hospital of Shanxi Medical University, Taiyuan, China
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Background: Rheumatoid arthritis (RA) is associated with an elevated risk of coronary heart disease (CHD) due to a complex interplay of traditional cardiovascular risk factors and RAspecific mechanisms. This study aimed to identify key risk factors for CHD in RA patients and develop a nomogram model for individualized risk prediction. Methods: A retrospective study was conducted involving 258 RA patients, including 32 with CHD and 226 without CHD, admitted between January 2021 and August 2024. Demographic, clinical, and laboratory data were collected. Multivariate logistic regression analysis identified independent risk factors, which were incorporated into a nomogram model. The model's performance was evaluated using the receiver operating characteristic (ROC) curve, calibration plots, and decision curve analysis (DCA). Internal validation was performed using bootstrap resampling. Results: Key risk factors for CHD in RA patients included hypertension, HbA1c, RA duration, carotid plaque burden, uric acid, and ECG abnormalities. The nomogram demonstrated excellent discriminative ability, with an area under the ROC curve (AUC) of 0.868 (95% CI: 0.819-0.916) and robust calibration (P = 0.908). Internal validation confirmed its reliability (AUC = 0.866). DCA indicated that the nomogram provided superior clinical utility by optimizing the net benefit across a range of threshold probabilities. Conclusions: This study identified hypertension, elevated HbA1c, prolonged RA duration, carotid plaque burden, increased uric acid levels, and ECG abnormalities as significant risk factors for CHD in RA patients. A nomogram prediction model incorporating these factors was developed, exhibiting outstanding discriminatory and calibration capabilities.
Keywords: Rheumatoid arthritis, coronary heart disease, Nomogram model, Risk factors, predictive analysis
Received: 09 Jan 2025; Accepted: 26 May 2025.
Copyright: © 2025 Che, Zhao, An, Wang, Guo and Xu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Ke Xu, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Third Hospital of Shanxi Medical University, Taiyuan, China
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