Division of Cardiology, Department of Internal Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China; Hubei Key Laboratory of Genetics and Molecular Mechanisms of Cardiological Disorders, Wuhan 430030, China.
Department of Epidemiology and Medical Statistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China.
Int J Cardiol. 2021 Mar 1;326:30-34. doi: 10.1016/j.ijcard.2020.09.070. Epub 2020 Oct 1.
Machine learning (ML) may be helpful to simplify the risk stratification of coronary artery disease (CAD). The current study aims to establish a ML-aided risk stratification system to simplify the procedure of the diagnosis of CAD.
5819 patients with coronary artery angiography (CAG) from July 2015 and December 2018 in our hospital, 2583 patients (aged 56 ± 11, <50% stenosis) and 3236 patients (aged 60 ± 10, ≥50% stenosis), available on age, sex, history of smoking, systolic and diastolic blood pressure, total cholesterol level, low- and high-density lipoprotein, triglyceride level, glycosylated hemoglobin A1c and uric acid were included in the ensemble model of ML. Receiver-operating characteristic curves showed that area-under-the-curve of the training data (90%) and the testing data (10%) were 0.81 and 0.75 (P = 0.006483). The validation data of 582 patients with CAG from July 2019 to September 2019 in our hospital showed the same predictive rate of the testing data. The low-risk group (risk probability<0.2) without the treatment of hypertension, diabetes and CAD could be probably excluded the diagnosis of CAD, the moderate-risk group (risk probability 0.2-0.8) would need further examination, and high-risk group (risk probability>0.8) would suggested to perform CAG directly.
Machine learning-aided detection system with the clinical data of age, sex, history of smoking, systolic and diastolic blood pressure, total cholesterol level, low- and high-density lipoprotein, triglyceride level, glycosylated hemoglobin A1c and uric acid could be helpful for the risk stratification of prediction for the coronary artery disease.
机器学习(ML)可能有助于简化冠状动脉疾病(CAD)的风险分层。本研究旨在建立一个 ML 辅助的风险分层系统,以简化 CAD 的诊断程序。
纳入我院 2015 年 7 月至 2018 年 12 月行冠状动脉造影(CAG)的 5819 例患者,其中 2583 例(年龄 56±11 岁,狭窄<50%)和 3236 例(年龄 60±10 岁,狭窄≥50%)患者,使用年龄、性别、吸烟史、收缩压和舒张压、总胆固醇水平、低和高密度脂蛋白、甘油三酯水平、糖化血红蛋白 A1c 和尿酸进行 ML 集成模型。受试者工作特征曲线显示训练数据(90%)和测试数据(10%)的曲线下面积分别为 0.81 和 0.75(P=0.006483)。我院 2019 年 7 月至 9 月 CAG 的 582 例验证数据显示,与测试数据具有相同的预测率。低风险组(风险概率<0.2),未接受高血压、糖尿病和 CAD 治疗,可能排除 CAD 诊断;中风险组(风险概率 0.2-0.8)需要进一步检查;高风险组(风险概率>0.8)建议直接进行 CAG。
使用年龄、性别、吸烟史、收缩压和舒张压、总胆固醇水平、低和高密度脂蛋白、甘油三酯水平、糖化血红蛋白 A1c 和尿酸等临床数据的 ML 辅助检测系统有助于预测 CAD 的风险分层。