Yang Liu, Du Li, Ge Yuanyuan, Ou Muhui, Huang Wanyan, Wang Xianmei
Department of Cardiology, The Affiliated 920th Hospital of Joint Logistics Support Force, Kunming Medical University, Kunming, China.
Department of Cardiology, 920th Hospital of Joint Logistics Support Force, People's Liberation Army of China (PLA), Kunming, Yunnan, China.
BMC Cardiovasc Disord. 2025 Jan 23;25(1):36. doi: 10.1186/s12872-025-04480-7.
This study aimed to evaluate the predictive performance of inflammatory and nutritional indices for adverse cardiovascular events (ACE) in patients with acute myocardial infarction (AMI) after percutaneous coronary intervention (PCI) using a machine learning (ML) algorithm.
AMI patients who underwent PCI were recruited and randomly divided into non/ACE groups. Inflammatory and nutritional indices were graded according to the laboratory examination reports. Logistic Regression was used to screen for factors that were significant for ML model establishment. The performances of the algorithms were evaluated in terms of accuracy, kappa, F1, receiver operating characteristic, precision recall curve, etc. RESULTS: Age, LVEF%, Killip Grade, heart rate, creatinine, albumin, neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), and prognostic nutritional index (PNI) were significantly correlated with ACE by Logistic regression analysis (P < 0.05). These nine factors were employed to establish stepwise regression (SR), random forest (RF), naïve Bayes (NB), decision trees (DT), and artificial neutron network (ANN), whose performances were evaluated in terms of accuracy, kappa, F1, receiver operating characteristic, precision recall curve, etc. The accuracy of the decision tree was greater than that of other trees. The area under the curves was the highest in the ANN model compared with the other models.
ANN predictive performance had an advantage over other ML algorithms based on age, LVEF%, Killip Grade, heart rate, creatinine, albumin, NLR, PLR, and PNI.
本研究旨在使用机器学习(ML)算法评估经皮冠状动脉介入治疗(PCI)后急性心肌梗死(AMI)患者炎症和营养指标对不良心血管事件(ACE)的预测性能。
招募接受PCI的AMI患者并随机分为非ACE组/ACE组。根据实验室检查报告对炎症和营养指标进行分级。使用逻辑回归筛选对建立ML模型有意义的因素。从准确性、kappa值、F1值、受试者工作特征曲线、精确召回率曲线等方面评估算法性能。结果:通过逻辑回归分析,年龄、左心室射血分数(LVEF%)、Killip分级、心率、肌酐、白蛋白、中性粒细胞/淋巴细胞比值(NLR)、血小板/淋巴细胞比值(PLR)和预后营养指数(PNI)与ACE显著相关(P < 0.05)。利用这九个因素建立逐步回归(SR)、随机森林(RF)、朴素贝叶斯(NB)、决策树(DT)和人工神经网络(ANN),并从准确性、kappa值、F1值、受试者工作特征曲线、精确召回率曲线等方面评估其性能。决策树的准确性高于其他树。与其他模型相比,ANN模型的曲线下面积最高。
基于年龄、LVEF%、Killip分级、心率、肌酐、白蛋白、NLR、PLR和PNI,ANN的预测性能优于其他ML算法。