Prognostic Value of Machine Learning-based Time-to-Event Analysis Using Coronary CT Angiography in Patients with Suspected Coronary Artery Disease.
Radiol Cardiothorac Imaging
; 5(2): e220107, 2023 Apr.
Article
em En
| MEDLINE
| ID: mdl-37124636
ABSTRACT
Purpose:
To assess the long-term prognostic value of a machine learning (ML) approach in time-to-event analyses incorporating coronary CT angiography (CCTA)-derived and clinical parameters in patients with suspected coronary artery disease. Materials andMethods:
The retrospective analysis included patients with suspected coronary artery disease who underwent CCTA between October 2004 and December 2017. Major adverse cardiovascular events were defined as the composite of all-cause death, myocardial infarction, unstable angina, or late revascularization (>90 days after index scan). Clinical and CCTA-derived parameters were assessed as predictors of major adverse cardiovascular events and incorporated into two models a Cox proportional hazards model with recursive feature elimination and an ML model based on random survival forests. Both models were trained and validated by employing repeated nested cross-validation. Harrell concordance index (C-index) was used to assess the predictive power.Results:
A total of 5457 patients (mean age, 61 years ± 11 [SD]; 3648 male patients) were evaluated. The predictive power of the ML model (C-index, 0.74; 95% CI 0.71, 0.76) was significantly higher than the Cox model (C-index, 0.71; 95% CI 0.68, 0.74; P = .02). The ML model also outperformed the segment stenosis score (C-index, 0.69; 95% CI 0.66, 0.72; P < .001), which was the best performing CCTA-derived parameter, and patient age (C-index, 0.66; 95% CI 0.63, 0.69; P < .001), the best performing clinical parameter.Conclusion:
An ML model for time-to-event analysis based on random survival forests had higher performance in predicting major adverse cardiovascular events compared with established clinical or CCTA-derived metrics and a conventional Cox model.Keywords Machine Learning, CT Angiography, Cardiac, Arteries, Heart, Arteriosclerosis, Coronary Artery DiseaseSupplemental material is available for this article.© RSNA, 2023.
Texto completo:
1
Base de dados:
MEDLINE
Tipo de estudo:
Prognostic_studies
Idioma:
En
Revista:
Radiol Cardiothorac Imaging
Ano de publicação:
2023
Tipo de documento:
Article
País de afiliação:
Alemanha