Logo

American Heart Association

  96
  0


Final ID: P3083

Characterization of the Course of Heart Disease using Multimorbidity-adjusted Life Year (MALY): A Multi-state Non-Markov Framework

Abstract Body: Background. In cardiovascular epidemiology, heart disease has been largely investigated by focusing on a single (or composite) endpoint. A few studies examined the disease course using multi-state Markov models, assuming the current disease state is independent of past states. Markov models are unsuitable to heart disease due to three reasons: First, risk factors interplay and affect future disease risk; second, Markov assumption does not allow for multimorbidity, a common condition for heart disease; and third, the estimated transition probabilities are time-specific and indirect for public health use. Methods. We have developed a multi-state non-Markov framework that splits disease state into substates by conditioning on past states (Ding et al. BMC Medical Research Methodology. 2024. In revision. doi: https://doi.org/10.1101/2024.09.18.24313882). As the substates track history of past states, transition rates between substates can be synthesized into a summary estimate, multimorbidity-adjusted life year (MALY) that represents the adjusted life year in full health. The derivation of MALY can be found in our second paper (Ding et al. medRxiv. 2024.doi: https://doi.org/10.1101/2024.09.18.24313882). In this study, we applied our framework to characterize the course of heart disease among participants enrolled in the Atherosclerosis Risk in Communities Study (ARIC). ARIC data was obtained from NHLBI BioLINCC. Results. We modeled the course of heart disease in five states: healthy, at metabolic risk, coronary heart disease (CHD), heart failure, and mortality (Figure 1). The disability weights assigned to each disease state is shown in Figure 2. In this mid- to old-age population, the estimated MALY was 24.13 (95% CI: 16.55, 32.06) years (Figure 3). The multimorbidity-adjusted life expectancy was higher among women (79.29 [95% CI: 77.42, 81.57] years) than men (77.07 [95% CI: 74.37, 80.05] years), and was higher among Whites (79.04 [95% CI: 77.05, 81.31] years) than Blacks (75.49 [95% CI: 73.19, 79.30] years). Impact. MALY summarizes the course of heart disease into one estimate and can be used in comparative effectiveness of disease intervention in the near future.
  • Ding, Ming  ( The University of North Carolina at Chapel Hill , Chapel Hill , North Carolina , United States )
  • Lin, Feng-chang  ( The University of North Carolina at Chapel Hill , Chapel Hill , North Carolina , United States )
  • Meyer, Michelle  ( The University of North Carolina at Chapel Hill , Chapel Hill , North Carolina , United States )
  • Author Disclosures:
    Ming Ding: DO NOT have relevant financial relationships | Feng-Chang Lin: No Answer | Michelle Meyer: No Answer
Meeting Info:
Session Info:

PS03.07 Methodology and Data Science

Saturday, 03/08/2025 , 05:00PM - 07:00PM

Poster Session

More abstracts on this topic:
Endovascular Therapy Vs. Medical Management In Isolated Anterior Cerebral Artery Acute Ischemic Stroke: A Multinational Multicenter Propensity Score-Weighted Study

Salim Hamza, Guenego Adrien, Dmytriw Adam, Yedavalli Vivek, Koneru Manisha, Pulli Benjamin, Abushehab Nimer, Lakhani Dhairya, Musmar Basel, Faizy Tobias, Heit Jeremy, Wintermark Max

Changes in EQ-5D-5L with Aficamten in Obstructive Hypertrophic Cardiomyopathy (oHCM): the SEQUOIA-HCM Trial

Schulze Christian, Kwong Raymond, Maron Martin, Masri Ahmad, Nassif Michael, Olivotto Iacopo, Spertus John, Veselka Josef, Butzner Michael, Heitner Stephen, Jacoby Daniel, Abraham Theodore, Kupfer Stuart, Malik Fady, Meng Lixin, Shreay Sanatan, Wohltman Amy, Maurer Mathew, Barriales-villa Roberto, Claggett Brian, Coats Caroline, Garcia-pavia Pablo, Hagege Albert, Januzzi James, Kulac Ian

More abstracts from these authors:
Projecting Disease Paths over the Course of Heart Disease: A Multi-state Non-Markov Framework

Ding Ming, Lin Feng-chang, Meyer Michelle

Agreement of Non-Invasive Devices that Measure Pulse Wave Velocity: VaSera vs VICORDER

Pagan Lassalle Patricia, Kerr Zachary, Barone Gibbs Bethany, Moore Justin, Loop Matthew, Meyer Michelle

You have to be authorized to contact abstract author. Please, Login
Not Available