Abstract P280: Revisiting CVD Risk Prediction Using Machine Learning Approaches: A Case Study

Abstract

Introduction: Applications of machine learning (ML) methods have been demonstrated by the recent FDA approval of new ML-based biomedical image processing methods. In this study, we examine applications of ML, specifically artificial neural networks (ANN), for predicting risk of cardiovascular (CV) events. Hypothesis: We hypothesized that using the same CV risk factors, ML-based CV prediction models can improve the performance of current predictive models. Methods: Justification for the Use of Statins in Prevention: An Intervention Trial Evaluating Rosuvastatin (JUPITER; NCT00239681) is a multi-ethnic trial that randomized non-diabetic participants with LDL-C<130 mg/dL and hsCRP≥2 mg/L to rosuvastatin versus placebo. We restricted the analysis to white and black participants allocated to the placebo arm, and estimated the race- and sex-specific Pooled Cohorts Equations (PCE) 5-year risk score using race, sex, age, HDL-C, total cholesterol, systolic BP, antihypertensive medications, and smoking. A total of 218 incident CV cases occurred (maximum follow-up 5 years). For every participant in the case group, we randomly selected 4 controls from the placebo arm after stratifying for the baseline risk factors (Table 1). The risk factors from a total of n=1,090 participants were used to train and test the ANN model. We used 80% of the participants (n=872) for designing the network and left out 20% of the data (n=218) for testing the predictive model. We used the TensorFlow software to design, train, and evaluate the ANN model. Results: We compared the performances of the ANN and the PCE score on the 218 test subjects (Figure 1). The high AUC of the neural network (0.85; 95% CI 0.78-0.91) on this dataset suggests advantages of machine learning methods compared to the current methods. Conclusions: This result demonstrates the potential of machine learning methods for enhancing and improving the current techniques used in cardiovascular risk prediction and should be evaluated in other cohorts.