Short-Term Risk Estimation and Treatment Planning for Cardiovascular Disease Patients after First Diagnostic Catheterizations with Machine Learning Models

Abstract

Cardiovascular disease (CVD) is the leading cause of death. CVD symptoms may develop within a short-term after diagnostic catheterizations and lead to life-threatening situations. This study is the first to apply machine learning (ML) methods to predict subsequent adverse cardiovascular events/treatments for patients within 90 days after their first diagnostic catheterizations. Patients (6539) without previously diagnosed CVD were selected from the DukeCath dataset. Ten ML methods were used. Three medical outcomes, varied cardiovascular-related scenarios, percutaneous coronary intervention (PCI) treatments, and coronary artery bypass graft (CABG) treatments, were targeted individually. With patient medical history, vital measurements, laboratory results, and the number of diseased vessels, the random forest classifier (RFC) performed best in predicting combined cardiovascular scenarios, including CABG, PCI, valve surgery (VS), stroke, and myocardial infarction (MI), achieving accuracy: 88.17%, sensitivity: 89.72%, specificity: 86.98%, area under receiver operating characteristic (AUROC): 91.68%. The gradient boosting classifier (GBC) performed best in predicting the PCI and CABG treatments (PCI treatments: accuracy: 89.21%, sensitivity: 90.20%, specificity: 88.74%, AUROC: 94.16%; CABG treatments: accuracy: 93.86%, sensitivity: 77.57%, specificity: 96.23%, AUROC: 96.47%). Our results show that the ML applications effectively identify high-risk patients, can provide diagnostic assistance in cardiovascular treatment planning, and improve outcomes in cardiovascular medicine.