Asthma is very common in the UK, affecting 5.4 million people. People with milder disease can usually be managed successfully within primary care, by their GP or asthma nurse, and often have “well controlled disease” and experience relatively few adverse effects, such as asthma attacks (also known as exacerbations). However, some studies have suggested that some people with asthma may be at greater risk of having other conditions, in particular cardiovascular disease (e.g. a heart attack or a stroke) than people without asthma. Who is at risk though is not entirely clear, and it may be that certain things about having asthma increase a person’s risk. This study aims to use existing tools that look at certain factors and how they are associated with cardiovascular disease to create a personalised risk prediction model for cardiovascular disease in people with asthma. Information from this prediction model could then be used in clinical practice to help reduce people’s risk.
In the UK, over 5.4 million people have asthma, and asthma accounts for over 65,000 hospital admissions and 1,000 deaths annually. Previous studies have suggested that people with asthma may be at increased risk of developing cardiovascular disease compared with the general population. Understanding whether there are specific factors that affect the likelihood of having a cardiovascular event in people with asthma and how this may differ from one individual to the next has not been fully investigated. Our objective is to develop a personalised risk prediction model for cardiovascular events in people with asthma by exploring factors collected in routine data that may be associated with cardiovascular events. We will include a cohort of people with asthma aged 18 years and older and investigate factors associated with cardiovascular disease using CPRD Aurum data linked with hospital data, specifically HES APC, HES A&E, ONS mortality data and socioeconomic status (IMD) data. The study period will be 2010 to 2019. We will determine risk factors for prediction of cardiovascular events using logistic regression and consider other methods such as random forest. Information from this prediction model could then be used in clinical practice to help reduce people’s risk.
Outcomes to be measured: a composite measure (binary indicator) for having at least one cardiovascular event recorded within 12 months from their asthma index date. Cardiovascular events could have been recorded in either HES APC or Office for National Statistics (ONS) mortality data. Cardiovascular events defining our outcome variable were one the following types of cardiovascular complications: acute coronary syndrome (ACS), stroke, arrhythmia and heart failure (HF).
Jennifer Quint - Chief Investigator - Imperial College London
Constantinos Kallis - Corresponding Applicant - Imperial College London
HES Accident and Emergency;HES Admitted Patient Care;ONS Death Registration Data;Patient Level Index of Multiple Deprivation