BIOMARKER COMPOSITIONS SPECIFIC TO CORONARY HEART DISEASE PATIENTS AND USES THEREOF

Abstract

The present invention relates to a disease-specific metabolite profile, and particularly to a biomarker composition obtained by screening from urine-specific metabolite profiles of coronary heart disease subjects. The present invention also relates to a use of the biomarker compositions in risk assessment, diagnosis, early diagnosis, or pathological staging of coronary heart disease, and to a method for risk assessment, diagnosis, early diagnosis, or pathological staging of coronary heart disease. The biomarker composition as provided by the present invention can be used for early diagnosis of coronary heart disease and has high sensitivity, good specificity and good application prospects.

Claims

1. A biomarker composition, comprising at least one or more selected from the following Biomarkers 1 to 8: Biomarker 1, which has a mass-to-charge ratio of 356.07±0.4 amu, and a retention time of 606.57±60 s; Biomarker 2, which has a mass-to-charge ratio of 284.18±0.4 amu, and a retention time of 538.89±60 s; Biomarker 3, which has a mass-to-charge ratio of 445.06±0.4 amu, and a retention time of 494.89±60 s; Biomarker 4, which has a mass-to-charge ratio of 268.19±0.4 amu, and a retention time of 589.52±60 s; Biomarker 5, which has a mass-to-charge ratio of 342.03±0.4 amu, and a retention time of 625.52±60 s; Biomarker 6, which has a mass-to-charge ratio of 324.0459±0.4 amu, and a retention time of 612.39±60 s; Biomarker 7, which has a mass-to-charge ratio of 324.0457±0.4 amu, and a retention time of 652.06±60 s; and Biomarker 8, which has a mass-to-charge ratio of 307.02±0.4 amu, and a retention time of 607.78±60 s.

2. The biomarker composition according to claim 1, comprising at least Biomarkers 1 to 3.

3. The biomarker composition according to claim 1, comprising Biomarkers 1 to 8.

4. A reagent composition, comprising a reagent for detecting the biomarker composition according to claim 1.

5-7. (canceled)

8. A method for risk assessment, diagnosis, early diagnosis or pathological staging of coronary heart disease, comprising a step of determining content of each biomarker of the biomarker composition according to claim 1 in a sample of a subject.

9. The method according to claim 8, wherein a liquid chromatography-mass spectrometry method is used for determining content of each biomarker of the biomarker composition in a sample of a subject.

10. The method according to claim 8, wherein the method further comprises a step of establishing a training set for contents of the biomarker composition in samples of a coronary heart disease subject and a normal subject.

11. The method according to claim 10, wherein the training set is established by using a multivariate statistical classification model.

12. The method according to claim 11, wherein the training set comprises data as shown in Table 2.

13. The method according to claim 8, wherein the method further comprises a step of comparing the content of each biomarker of the biomarker composition in a sample of a subject to the data of the training set, and the training set is for contents of the biomarker composition in samples of a coronary heart disease subject and a normal subject.

14. The method according to claim 13, wherein the training set is established by using a multivariate statistical classification model.

15. The method according to claim 14, wherein the training set comprises data as shown in Table 2.

16. The method according to claim 13, wherein the step of comparing the content of each biomarker is carried out by using a receiver operating characteristic curve.

17. The method according to claim 16, wherein the result from the step of comparing the content of each biomarker is interpreted by a method comprising: if a subject is assumed to be a non-coronary heart disease subject, and his probability of non-coronary heart disease diagnosed by ROC is less than 0.5 or his probability of coronary heart disease diagnosed by ROC is greater than 0.5, the subject is determined to have a high probability or a higher risk of coronary heart disease, or is diagnosed as a patent with coronary heart disease.

18-27. (canceled)

28. The method according to claim 8, wherein the sample is urine.

29. The method according to claim 11, wherein the multivariate statistical classification model is a random forest model.

30. The biomarker composition according to claim 2, further comprising one or more of Biomarkers 4 to 8.

Description

BRIEF DESCRIPTION OF THE DRAWINGS

[0078] FIG. 1 shows total ion chromatograms of mass spectrometry for coronary heart disease group (a) and normal group (b).

[0079] FIG. 2 shows PLS-DA score plots, in which prisms (white) represent normal group, triangles (black) represent coronary heart disease group.

[0080] FIG. 3 shows a loading-plot of principal components, in which triangles (black) represent variables with VIP value greater than 1.

[0081] FIG. 4 shows a Volcano-plot, in which differential metabolites are located above the horizontal dotted line, wherein the materials (black triangles) on the ambilateral sides of the two vertical dashed lines are metabolites with fold-change greater than 1.2 and Q-value less than 0.05, and the materials (gray spheres) between the two vertical dashed lines are metabolites with fold-change less than 0.8 and Q-value less than 0.05.

[0082] FIG. 5 shows S-plot, in which prisms (black) represent variables with VIP greater than 1.

[0083] FIG. 6 shows ROC diagram of random forest model (Random forest model), in which Training ROC is based on the training set, AUC=1; and Test ROC is based on the test set, AUC=0.9449.

[0084] FIG. 7 shows ROC test set diagram in which mass-to-charge ratios 356.07 and 445.06 are randomly removed from the training set, AUC=0.9289.

[0085] FIG. 8 shows diagram for random combinations of 8 potential markers, in which the left side of the vertical line mark gives 3 markers that need to be tested at least.

SPECIFIC MODELS FOR CARRYING OUT THE INVENTION

[0086] While the embodiments of the present invention will be described in detail with reference to the following examples, it will be understood by those skilled in the art that the following examples are intended to be illustrative of the invention and are not to be taken as limiting the scope of the invention. In the examples, when specific conditions are not given, conventional conditions or conditions recommended by the manufacturer are employed. The used reagents or instruments which manufacturers are not given are all conventional products commercially available in the markets.

[0087] The urine samples of coronary heart disease and normal subjects in the present invention are from the Guangdong General Hospital.

Example 1

[0088] 1.1 Collection of samples: morning urine samples of volunteers were collected, immediately placed and stored in −80° C. low temperature refrigerator. A total of 52 urine samples were collected from the normal group and 40 urine samples were collected from the coronary heart disease group.

[0089] 1.2 Treatment of samples: frozen samples were thawed at room temperature, 500 μL of each urine sample was taken and placed in 2.0 mL centrifuge tube, added with 500 μL of methanol for dilution, centrifuged at 10000 rpm for 5 min, for standby.

[0090] 1.3 Analysis by Liquid Chromatography-Mass Spectrometry

[0091] Instrument and Equipment

[0092] HPLC-MS-LTQ Orbitrap Discovery (Thermo, Germany)

[0093] Chromatographic Conditions

[0094] Column: C18 column (150 mm×2.1 mm, 5 μm); Solvent A was 0.1% (v/v) formic acid/water, and solvent B was 0.1% (v/v) formic acid/methanol; gradient elution program: 0˜3 min, 5% B, 3˜36 min, 5%˜80% B, 36˜40 min, 80%˜100% B, 40˜45 min, 100% B, 45˜50 min, 100%˜5% B, 50˜60 min, 5% B; flow rate: 0.2 mL/min; injection volume: 20 μL.

[0095] Mass Spectrometry Conditions

[0096] ESI ion source, positive ion mode for data acquisition, the mass scanning range was 50˜1000 mass-to-charge (m/z). Ion source parameters ESI: sheath gas was 10, auxiliary air was 5, capillary temperature was 350° C., spray voltage was 4.5 KV.

[0097] 1.4 Data Processing

[0098] XCMS software (e.g., http://metlin.scripps.edu/xcms/) was used for peak detection and peak matching of raw data; and R software using PLS-DA (partial least squares—discriminant analysis) was used for pattern recognition analysis of differential variables of the metabolite profile of coronary heart disease group (FIG. 1a) and the metabolite profile of normal group (FIG. 1b), so as to establish PLS-DA mathematical model.

[0099] 1.5 Comparison and Determination of Characteristic Metabolite Profiles

[0100] The urine metabolite profile of coronary heart disease patients (FIG. 1) was established by comparing the urine metabolite profiles of the normal group and the coronary heart disease group. The results showed that there were significant differences in the urine metabolite profiles between the normal group and the coronary heart disease group.

Example 2

[0101] 2.1 Sample collection: morning urine samples of volunteers were collected, immediately placed and stored in −80° C. low temperature refrigerator. A total of 52 urine samples were collected from the normal group and 40 urine samples were collected from the coronary heart disease group.

[0102] 2.2 Sample treatment: frozen samples were thawed at room temperature, 500 μL of each urine sample was taken and placed in 2.0 mL centrifuge tube, added with 500 μL of methanol for dilution, centrifuged at 10000 rpm for 5 min, for standby.

[0103] 2.3 Analysis by Liquid Chromatography-Mass Spectrometry

[0104] Instrument and Equipment

[0105] HPLC-MS-LTQ Orbitrap Discovery (Thermo, Germany)

[0106] Chromatographic Conditions

[0107] Column: C18 column (150 mm×2.1 mm, 5 μm); mobile phase A: 0.1% formic acid aqueous solution, mobile phase B: 0.1% formic acid in acetonitrile solution; gradient elution program: 0˜3 min, 5% B, 3˜36 min, 5%˜80% B, 36˜40 min, 80%˜100% B, 40˜45 min, 100% B, 45˜50 min, 100% 5% B, 50˜60 min, 5% B; flow rate: 0.2 mL/min; injection volume: 20 μL.

[0108] Mass Spectrometry Conditions

[0109] ESI ion source, positive ion mode for data acquisition, scanning mass m/z 50˜1000. Ion source parameters ESI: sheath gas was 10, auxiliary air was 5, capillary temperature was 350° C., cone hole voltage was 4.5 KV.

[0110] 2.4 Data Processing

[0111] XCMS software was used for relevant pretreatment of raw data to obtain a two-dimensional matrix data, and wilcox-test was used to statistically determine significant differences of peaks of metabolites; and PLS-DA (partial least squares—discriminant analysis) was used for pattern recognition analysis of differential variables of the metabolite profile of coronary heart disease group (FIG. 1a) and the metabolite profile of normal group (FIG. 1b), and potential biomarkers were screened out by VIP, Volcano-plot and S-plot in combination.

[0112] 2.5 Metabolic Profile Analysis and Potential Biomarkers

[0113] 2.5.1 Orthogonal Partial Least Squares Discriminant Analysis (PLS-DA)

[0114] PLS-DA method was used to distinguish the normal group and the coronary heart disease group, and potential markers were further screened by VIP values (loading plot of principal component analysis) (FIG. 3), Volcano-plot (FIG. 4) and S-plot (FIG. 5). It was shown in FIG. 3 and FIG. 4 that there were significant different metabolites in the normal group and coronary heart disease group. As shown in FIG. 5, each point in the S-plot represented a variable, and the S-plot graph showed the relevance of the variable to the model. The black prism-tagged variable was a variable with VIP greater than 1, which had a large deviation and a good correlation with the model (see FIG. 2 and FIG. 5).

[0115] 2.5.2 Potential Biomarkers

[0116] The potential markers were screened according to the VIP values of the PLS-DA model for pattern cognition. The variables with VIP values greater than 1 were extracted from the PLS-DA model, and variables with large deviation and relevance were further selected according to load chart, Volcano-plot and S-plot, and 8 potential biomarkers were obtained by further combining variables with P value of less than 0.05 and Q value of less than 0.05, which were shown in Table 1.

TABLE-US-00001 TABLE 1 Potential biomarkers Ratio Mass-to- (normal charge Retention group/coronary ratio time, heart disease VIP (amu) Rt (sec) group) P value Q value value 356.07 606.57 0.05 2.75E−11 1.53E−08 1.26 284.18 538.89 0.02 1.83E−05 2.72E−04 1.45 445.06 494.89 0.02 1.44E−11 1.20E−08 1.74 268.19 589.52 0.01 6.56E−04 6.21E−03 1.53 342.03 625.52 0.03 8.91E−09 3.81E−07 1.90 324.0459 612.39 0.03 2.24E−09 1.56E−07 1.93 324.0457 652.06 0.02 6.59E−09 3.13E−07 2.57 307.02 607.78 0.03 2.10E−09 1.56E−07 1.74

[0117] 2.5.4 Receiver Operating Characteristic Curve (ROC)

[0118] The eight potential markers were discriminated in the normal group and coronary heart disease group by using a random forest model (Random Forest).sup.[7] and receiver operating characteristic curve (ROC).sup.[8]. The data of peak areas of 92 metabolite profiles of the normal group and the coronary heart disease group were selected and used as training set via ROC modeling (see references [7] and [8]) (Table 2). In addition, 303 test samples (including 182 coronary heart disease samples and 121 normal control samples) were selected as test set. The test results showed AUC=0.9449, FN (false negative)=0.230, FP (false positive)=0.008 (FIG. 6). Thus, the present invention has high accuracy and specificity, and has good prospects to be developed as a diagnosis method to provide a basis for diagnosis of coronary heart disease.

TABLE-US-00002 TABLE 2 Data of training set metabolite profiles (peak area) Group (1: Coronary heart disease group; 0: normal Mass-to-charge ratio (amu) Sample No. group) 356.0722 284.1856 445.0662 268.191 342.0378 324.0459 324.0457 307.02 N165_11_10 0 0.050727 0 0.0081 0.000576 0 0.007244 0 0 N167_14_13 0 0.700671 0.491373 0.43858 0.258349 0.583474 1.01587 0.709247 0.996549 N168_6_6 0 0.017057 0.003273 0.022923 0.000506 0 0 0 0 N170_5_5 0 1.118726 0.763688 1.036212 0.587642 1.935456 1.544139 1.438488 1.665617 N171_10_9 0 0.585286 0.399349 0.195601 0.257848 0.771351 0.918791 0.759376 0.763014 N185_3_3 0 0.001756 0.002489 0.04602 0.001706 0.000674 0.001871 0.000765 0.004254 N186_2_2 0 0.033602 0.002031 0 0.000286 0.018214 0 0 0 N187_1_1 0 0.083965 0.018984 0.078802 0.024106 0.162598 0.231746 0.100976 0.214191 N190_2_2 0 0.055174 0.025052 0.011355 0.017505 0.045384 0.058801 0.040412 0.050481 N191_2_2 0 0.014361 0.000419 0 0 0.003741 0 0 0.026598 N195_2_2 0 0.071606 0.072388 0.065478 0.03979 0.096294 0.130355 0.07972 0.095388 N197_13_12 0 0.113316 0.126297 0.133139 0.091836 0.153965 0.15097 0.123104 0.230104 N198_1_1 0 0.13997 0.154741 0.118181 0.133976 0.386868 0.450153 0.311324 0.448939 N199_13_12 0 0.007775 0.018247 0.016699 0.010208 0.052443 0.006032 0.020938 0.06164 N200_2_2 0 0.014128 0.055363 0.002909 0.015098 0.00202 0 0.001985 0.01716 N201_2_2 0 0.014985 0.005288 0.005743 0.013153 0.004488 0.00455 0.007382 0.086503 N203_13_12 0 0.114562 0.000885 0 0.007605 0 0 0.003256 0.057085 N204_1_1 0 0.051158 0.082626 0.090507 0.054647 0.049881 0.059178 0.035429 0.059979 N205_1_1 0 0.009121 0.00669 0 0.004913 0.003084 0 0.008396 0.012356 N206_2_2 0 0.423082 0.000549 0.237519 0 0.388775 1.006219 0.538118 0.283513 N207_2_2 0 0.037572 0.009893 0 0.00414 0.002972 0 0 0.007073 N208_1_1 0 0.031229 0.031697 0 0.039781 0.010892 0 0.00776 0.004047 N209_2_2 0 0.056193 0.025581 0.00882 0.01507 0.007239 0 0.008259 0.011088 N212_1_1 0 0 0 0.006792 0.000325 0 0 0 0.021432 N213_1_1 0 0.022905 0.003433 0 0.000721 0 0 0.003124 0 N214_3_3 0 0.005787 0.000134 0.013291 0.00015 0 0 0.000927 0.011216 N215_2_2 0 0.009559 0.001665 0 0.000675 0 0.003649 0.003024 0.003294 N217_2_2 0 0.021546 0.012008 0 0.002519 0.010761 0.014342 0.005523 0.004285 N218_1_1 0 0.001903 0.00647 0.002823 0.003972 0.001288 0 0 0.002533 N220_3_3 0 0.037769 0.000147 0.021874 0.000497 0.061861 0.186411 0.096903 0.100274 N222_1_1 0 0.031056 0.006934 0.084298 0.013115 0.087239 0.115484 0.071167 0.09323 N223_1_1 0 0.022325 0.001591 0.005429 0.001879 0 0 0 0 N226_2_2 0 0.401971 0.290546 0.328433 0.201518 0.682477 0.427509 0.552805 0.669991 N227_2_2 0 0.014787 0.007046 0 0.005274 0.013257 0.002112 0.011434 0 N228_5_5 0 0.228112 0.540553 0.195533 0.168774 0.430204 0.322248 0.331633 0.503222 N229_6_6 0 0.141694 0.108248 0.083678 0.119914 0.383583 0.371522 0.212677 0.300032 N231_9_8 0 0.379711 0.360892 0.166288 0.206992 0.108167 0.136906 0.092083 0.119944 N232_6_6 0 0.047573 0.004747 0 0.000647 0.002274 0.00174 0 0 N233_5_5 0 0.040641 0.080729 0.0423 0.053298 0.050616 0.127117 0.07407 0.062576 N234_4_4 0 0.207284 0.200893 0.235156 0.150836 0.465188 0.399302 0.358934 0.341159 N235_6_6 0 0.008056 0.049746 0.006451 0.067002 0.020476 0.002431 0.005861 0.009006 N236_5_5 0 0.009005 0.000991 0 0.000181 0 0 0 0 N237_4_4 0 0.055985 0.016887 0.004479 0.0146 0.053198 0.06221 0.059575 0.040373 N238_4_4 0 1.900712 0.028984 1.165815 0.018644 1.571225 0.475648 1.529518 1.443399 N239_4_4 0 0.072683 0.136582 0.141065 0.120443 0.390014 0.499418 0.188908 0.214719 N241_4_4 0 0.004649 0.00051 0.038894 0 0 0 0 0.004573 N242_3_3 0 0.006202 0.005425 0.018052 0.007253 0 0 0.001196 0.012753 N243_5_5 0 0.21151 0.120443 0.229312 0.138598 0.476139 0.594607 0.389633 0.485419 N244_14_13 0 0.013491 0.000969 0.004027 0.00156 0 0 0.001553 0.065665 N245_5_5 0 0.076173 0.010746 0.002663 0.004756 0.008524 0.005277 0.003782 0.010315 N247_6_6 0 0.00508 0.001569 0 0.0019 0.001161 0.007967 0.000846 0.037039 N248_5_5 0 0.032339 0.000587 0 0.000437 0 0.008133 0 0 ZSL229_2_2 1 1.018531 3.950757 0.182069 0.636612 0.60125 1.097666 0.289254 0.494088 ZSL234_1_1 1 0.583531 3.435453 0.795557 1.709356 0.222236 0.761682 0.345999 0.187897 ZSL235_2_2 1 1.181361 0.152603 0.939668 0.047144 0.929618 4.035717 1.292228 1.156159 ZSL236_3_3 1 2.081281 0.018304 1.898479 0.006197 1.762673 1.136454 1.725205 1.479569 ZSL237_4_4 1 6.492563 0.006244 14.87724 0.007235 22.19462 24.85611 17.40065 10.64721 ZSL238_3_3 1 1.702545 11.98425 1.222842 7.900273 5.012054 0.637683 2.124289 3.730898 ZSL239_6_6 1 2.162367 0.003073 4.745232 0.003427 5.442023 3.975631 3.293823 6.143599 ZSL240_6_6 1 0.16421 0 0.047093 0.002727 0.044366 0.156119 0.049045 0.060174 ZSL248_5_5 1 1.657123 6.083406 1.777601 2.504562 2.333015 4.393965 1.966348 1.972406 ZSL250_5_5 1 8.714595 14.32087 26.98067 20.88803 15.94406 18.32642 13.07876 13.96109 ZSL252_6_6 1 3.031666 0.008082 7.529829 0 7.073493 7.170141 2.691871 5.640622 ZSL261_6_6 1 6.014641 0.189933 12.72496 13.93657 13.44713 32.8584 16.86183 10.9035 ZSL265_6_6 1 11.22025 17.09913 18.15472 8.728776 9.174703 16.91267 20.83132 14.80546 ZSL266_14_13 1 0.115196 0.088163 0.008972 0.110673 0.136602 0.0244 0.030063 0.059366 ZSL267_5_5 1 1.49161 4.122593 2.400876 0.411089 1.302119 1.000125 1.343585 0.973993 ZSL270_5_5 1 3.004328 0.013414 4.431113 0.003272 6.364588 10.60903 7.162436 9.64398 ZSL271_5_5 1 4.564883 0.025178 2.33377 0.00848 5.587718 16.44589 6.301333 5.033009 ZSL272_6_6 1 1.104237 11.81819 0.295694 20.48261 0.650639 0.350425 0.395211 0.463962 ZSL277_6_6 1 2.611821 0.00141 2.03553 0.000691 8.739621 7.052004 3.151162 5.215719 ZSL282_7_7 1 5.090599 0.00577 16.35812 0.000275 6.49348 20.55782 8.213584 7.685243 ZSL289_7_7 1 7.652603 0.003049 8.715061 0.011397 18.01092 26.7367 13.21022 11.30195 ZSL290_14_13 1 0.996549 4.390615 1.084703 6.741163 2.629733 3.284678 3.628341 3.778025 ZSL297_6_6 1 1.066514 5.967553 0.722559 2.93087 0.664882 0.223668 0.204465 0.333787 ZSL300_6_6 1 3.643793 1.006024 16.94684 0.148682 16.86828 4.310987 12.21613 12.20316 ZSL301_6_6 1 0.199107 0.034298 0.143035 0.024563 0.098331 0.061123 0.045024 0.103692 ZSL302_5_5 1 5.924905 5.237627 2.289743 5.691231 11.94612 20.6828 17.4122 14.4408 ZSL312_5_5 1 0.035975 21.19713 0.00893 9.281833 0 0 0 0.005924 ZSL314_6_6 1 0.555908 3.59192 0.177668 0.604776 0.264665 0.00398 0.11581 0.17875 ZSL315_6_6 1 1.680925 3.099505 1.479545 5.030586 2.667323 4.141096 1.662493 2.903288 ZSL317_14_13 1 3.527125 0.012436 3.266543 0.001539 6.087814 13.33405 6.072355 7.235422 ZSL318_6_6 1 0.675975 3.398881 0.798803 4.353942 1.998757 5.442052 2.292455 2.906209 ZSL330_14_13 1 1.011196 0.059638 1.455093 0.143674 0.274329 0.69689 0.947892 0.564808 ZSL332_5_5 1 12.04706 9.802246 30.04653 6.986533 18.30787 24.86612 24.13673 17.45268 ZSL334_6_6 1 0.116528 4.099484 0.038631 0.109829 0.005093 0 0 0 ZSL335_6_6 1 0.025725 0.001383 0.038073 0 0 0 0.001766 0 ZSL336_7_7 1 3.40415 0.022602 3.726221 0 17.21046 17.30863 10.59224 9.995526 ZSL338_14_13 1 2.714739 3.426387 9.516216 3.730436 2.373802 7.024976 2.591477 3.802353 ZSL340_13_12 1 3.615215 16.72375 4.245612 6.137015 5.698663 9.143185 7.359719 12.57524 ZSL349_7_7 1 0.655089 2.645769 0.133089 1.350477 0.096092 0 0.315811 0.152866 ZSL353_4_4 1 2.460175 8.463638 2.60743 7.497369 2.834242 6.970485 2.392618 3.338898

[0119] Using the random forest model to calculate the classification ability of the eight potential biomarkers for the obese group and the normal group, the results of the sorting ability (arranged from high to low) were shown in Table 3. The markers in the table should be tested using at least above 3 markers (FIG. 8), so that the AUC value was around 0.90 while maintaining high sensitivity and specificity.

TABLE-US-00003 TABLE 3 Classification ability of potential biomarkers Metabolite Interpreting Interpreting Mean Mean (mass-to-charge value of value of Decrease Decrease ratio) (amu) normal group obese group Accuracy Gini 356.07 0.150464 0.092498 0.121952 10.00917 445.06 0.104776 0.057948 0.082715 7.127041 284.18 0.080873 0.036778 0.06133 5.158795 324.0457 0.064424 0.043364 0.053989 6.110113 324.0459 0.055228 0.024179 0.041406 4.087854 342.03 0.052123 0.024192 0.039909 4.614609 268.19 0.068445 0.020407 0.045933 3.959031 307.02 0.033325 0.012134 0.024432 3.667505

[0120] If mass-to-charge ratios, such as 356.07 and 445.06, were randomly removed from the training set, the resultant ROC test set (the above 303 test set samples) had AUC=0.9289, AUC decreased significantly, FN=0.296 and FP=0.016, FN and FP significantly increased (FIG. 7), which indicated the ability for diagnosis of coronary heart disease decreased.

REFERENCES

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