Joint modelling of longitudinal lipids and time to coronary heart disease in the Jackson Heart Study
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(2020) 20:294
RESEARCH ARTICLE
Open Access
Joint modelling of longitudinal lipids and time to coronary heart disease in the Jackson Heart Study Wondwosen Kassahun-Yimer1* , Karen A. Valle3 , Adebamike A. Oshunbade2 , Michael E. Hall2 , Yuan-I. Min2 , Loretta Cain-Shields1 , Pramod Anugu2 and Adolfo Correa2
Abstract Background: Multiple longitudinal responses together with time-to-event outcome are common in biomedical studies. There are several instances where the longitudinal responses are correlated with each other and at the same time each longitudinal response is associated with the survival outcome. The main purpose of this study is to present and explore a joint modeling approach for multiple correlated longitudinal responses and a survival outcome. The method will be illustrated using the Jackson Heart Study (JHS), which is one of the largest cardiovascular studies among African Americans. Methods: Four longitudinal responses, i.e., total cholesterol (TC), high density lipoprotein (HDL) cholesterol, triglyceride (TG) and inflammation measured by high-sensitivity C-reactive protein (hsCRP); and time-to-coronary heart disease (CHD) were considered from the JHS. The repeated lipid and hsCRP measurements from a given subject overtime are likely correlated with each other and could influence the subject’s risk for CHD. A joint modeling framework is considered. To deal with the high dimensionality due to the multiple longitudinal profiles, we use a pairwise bivariate model fitting approach that was developed in the context of multivariate Gaussian random effects models. The method is further explored through simulations. Results: The proposed model performed well in terms of bias and relative efficiency. The JHS data analysis showed that lipid and hsCRP trajectories could exhibit interdependence in their joint evolution and have impact on CHD risk. Conclusions: We applied a unified and flexible joint modeling approach to analyze multiple correlated longitudinal responses and survival outcome. The method accounts for the correlation among the longitudinal responses as well as the association between each longitudinal response and the survival outcome at once. This helps to explore how the combination of multiple longitudinal trajectories could be related to the survival process. Keywords: Joint modeling, Multivariate longitudinal, Survival data, Correlated responses
*Correspondence: [email protected] Department of Data Science, University of Mississippi Medical Center, 2500 N State St, Jackson MS, 39216, USA Full list of author information is available at the end of the article 1
© The Author(s). 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article a
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