Improved long-term prognostic value of coronary CT angiography-derived plaque measures and clinical parameters on adverse cardiac outcome using machine learning.
Eur Radiol
; 31(1): 486-493, 2021 Jan.
Article
em En
| MEDLINE
| ID: mdl-32725337
ABSTRACT
OBJECTIVES:
To evaluate the long-term prognostic value of coronary CT angiography (cCTA)-derived plaque measures and clinical parameters on major adverse cardiac events (MACE) using machine learning (ML).METHODS:
Datasets of 361 patients (61.9 ± 10.3 years, 65% male) with suspected coronary artery disease (CAD) who underwent cCTA were retrospectively analyzed. MACE was recorded. cCTA-derived adverse plaque features and conventional CT risk scores together with cardiovascular risk factors were provided to a ML model to predict MACE. A boosted ensemble algorithm (RUSBoost) utilizing decision trees as weak learners with repeated nested cross-validation to train and validate the model was used. Performance of the ML model was calculated using the area under the curve (AUC).RESULTS:
MACE was observed in 31 patients (8.6%) after a median follow-up of 5.4 years. Discriminatory power was significantly higher for the ML model (AUC 0.96 [95%CI 0.93-0.98]) compared with conventional CT risk scores including Agatston calcium score (AUC 0.84 [95%CI 0.80-0.87]), segment involvement score (AUC 0.88 [95%CI 0.84-0.91]), and segment stenosis score (AUC 0.89 [95%CI 0.86-0.92], all p < 0.05). Similar results were shown for adverse plaque measures (AUCs 0.72-0.82, all p < 0.05) and clinical parameters including the Framingham risk score (AUCs 0.71-0.76, all p < 0.05). The ML model yielded significantly higher diagnostic performance compared with logistic regression analysis (AUC 0.96 vs. 0.92, p = 0.024).CONCLUSION:
Integration of a ML model improves the long-term prediction of MACE when compared with conventional CT risk scores, adverse plaque measures, and clinical information. ML algorithms may improve the integration of patient's information to enhance risk stratification. KEY POINTS ⢠A machine learning (ML) model portends high discriminatory power to predict major adverse cardiac events (MACE). ⢠ML-based risk stratification shows superior diagnostic performance for MACE prediction over coronary CT angiography (cCTA)-derived risk scores or clinical parameters alone. ⢠A ML model outperforms conventional logistic regression analysis for the prediction of MACE.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Doença da Artéria Coronariana
/
Estenose Coronária
/
Placa Aterosclerótica
Tipo de estudo:
Etiology_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Female
/
Humans
/
Male
Idioma:
En
Revista:
Eur Radiol
Assunto da revista:
RADIOLOGIA
Ano de publicação:
2021
Tipo de documento:
Article
País de afiliação:
Alemanha