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Gautam N, Mueller J, Alqaisi O, Gandhi T, Malkawi A, Tarun T, Alturkmani HJ, Zulqarnain MA, Pontone G, Al'Aref SJ. Machine Learning in Cardiovascular Risk Prediction and Precision Preventive Approaches. Curr Atheroscler Rep 2023; 25:1069-1081. [PMID: 38008807 DOI: 10.1007/s11883-023-01174-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/15/2023] [Indexed: 11/28/2023]
Abstract
PURPOSE OF REVIEW In this review, we sought to provide an overview of ML and focus on the contemporary applications of ML in cardiovascular risk prediction and precision preventive approaches. We end the review by highlighting the limitations of ML while projecting on the potential of ML in assimilating these multifaceted aspects of CAD in order to improve patient-level outcomes and further population health. RECENT FINDINGS Coronary artery disease (CAD) is estimated to affect 20.5 million adults across the USA, while also impacting a significant burden at the socio-economic level. While the knowledge of the mechanistic pathways that govern the onset and progression of clinical CAD has improved over the past decade, contemporary patient-level risk models lag in accuracy and utility. Recently, there has been renewed interest in combining advanced analytic techniques that utilize artificial intelligence (AI) with a big data approach in order to improve risk prediction within the realm of CAD. By virtue of being able to combine diverse amounts of multidimensional horizontal data, machine learning has been employed to build models for improved risk prediction and personalized patient care approaches. The use of ML-based algorithms has been used to leverage individualized patient-specific data and the associated metabolic/genomic profile to improve CAD risk assessment. While the tool can be visualized to shift the paradigm toward a patient-specific care, it is crucial to acknowledge and address several challenges inherent to ML and its integration into healthcare before it can be significantly incorporated in the daily clinical practice.
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Affiliation(s)
- Nitesh Gautam
- Division of Cardiology, Department of Internal Medicine, University of Arkansas for Medical Sciences, 4301 W. Markham St, Little Rock, AR, 72223, USA
| | - Joshua Mueller
- Department of Internal Medicine, University of Arkansas for Medical Sciences Northwest Regional Campus, Fayetteville, AR, USA
| | - Omar Alqaisi
- Department of Internal Medicine, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Tanmay Gandhi
- Department of Internal Medicine, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Abdallah Malkawi
- Division of Cardiology, Department of Internal Medicine, University of Arkansas for Medical Sciences, 4301 W. Markham St, Little Rock, AR, 72223, USA
| | - Tushar Tarun
- Division of Cardiology, Department of Internal Medicine, University of Arkansas for Medical Sciences, 4301 W. Markham St, Little Rock, AR, 72223, USA
| | - Hani J Alturkmani
- Division of Cardiology, Department of Internal Medicine, University of Arkansas for Medical Sciences, 4301 W. Markham St, Little Rock, AR, 72223, USA
| | - Muhammed Ali Zulqarnain
- Division of Cardiology, Department of Internal Medicine, University of Arkansas for Medical Sciences, 4301 W. Markham St, Little Rock, AR, 72223, USA
| | | | - Subhi J Al'Aref
- Division of Cardiology, Department of Internal Medicine, University of Arkansas for Medical Sciences, 4301 W. Markham St, Little Rock, AR, 72223, USA.
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Choi SY, Kim JW, Oh SH, Cheon S, Yee J, Kim SJ, Gwak HS, Chung JE. Prediction of medication-related osteonecrosis of the jaws using machine learning methods from estrogen receptor 1 polymorphisms and clinical information. Front Med (Lausanne) 2023; 10:1140620. [PMID: 37415765 PMCID: PMC10321771 DOI: 10.3389/fmed.2023.1140620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Accepted: 05/23/2023] [Indexed: 07/08/2023] Open
Abstract
Objective The purpose of this study was to evaluate the effect of estrogen receptor 1 (ESR1) polymorphisms on the development of medication-related osteonecrosis of the jaws (MRONJ) in women with osteoporosis. Methods A total of 125 patients taking bisphosphonates was evaluated the relationship between MRONJ occurrence and single nucleotide polymorphisms (SNPs) of ESR1. Clinical information was collected, including current age, treatment duration, and comorbidity. Univariate and Multivariable regression analyzes were performed to evaluate the independent predictive factors for MRONJ occurrence. Predictive models were constructed using machine learning methods such as Lasso regression, Random forest (RF), and Support vector machine (SVM). The area under the receiver-operating curve (AUROC) was used to evaluate the performance of a binary classifier. Result Two SNPs of ESR1 (rs4870056 and rs78177662) were significantly associated with MRONJ development. Patients with variant allele (A) of rs4870056 showed 2.45 times (95% CI, 1.03-5.87) the odds of MRONJ occurrence compared to those with wild-type homozygote (GG) after adjusting covariates. Additionally, carriers with variant allele (T) of rs78177662 had higher odds than those with wild-type homozygote (CC) (adjusted odds ratio (aOR), 2.64, 95% CI, 1.00-6.94). Among demographic variables, age ≥ 72 years (aOR, 3.98, 95% CI, 1.60-9.87) and bisphosphonate exposure ≥48 months (aOR, 3.16, 95% CI, 1.26-7.93) were also significant risk factors for MRONJ occurrence. AUROC values of machine learning methods ranged between 0.756-0.806 in the study. Conclusion Our study showed that the MRONJ occurrence was associated with ESR1 polymorphisms in osteoporotic women.
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Affiliation(s)
- Seo-Yong Choi
- College of Pharmacy and Institute of Pharmaceutical Science and Technology, Hanyang University, Ansan, Republic of Korea
| | - Jin-Woo Kim
- Department of Oral and Maxillofacial Surgery, School of Medicine, Ewha Womans University, Seoul, Republic of Korea
| | - Sang-Hyeon Oh
- College of Pharmacy and Institute of Pharmaceutical Science and Technology, Hanyang University, Ansan, Republic of Korea
| | - Seunghyun Cheon
- College of Pharmacy and Institute of Pharmaceutical Science and Technology, Hanyang University, Ansan, Republic of Korea
| | - Jeong Yee
- College of Pharmacy and Graduate School of Pharmaceutical Sciences, Ewha Womans University, Seoul, Republic of Korea
| | - Sun-Jong Kim
- Department of Oral and Maxillofacial Surgery, School of Medicine, Ewha Womans University, Seoul, Republic of Korea
| | - Hye Sun Gwak
- College of Pharmacy and Graduate School of Pharmaceutical Sciences, Ewha Womans University, Seoul, Republic of Korea
| | - Jee-Eun Chung
- College of Pharmacy and Institute of Pharmaceutical Science and Technology, Hanyang University, Ansan, Republic of Korea
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Xu Y, Ma Q, Ren J, Chen L, Guo W, Feng K, Zeng Z, Huang T, Cai Y. Using Machine Learning Methods in Identifying Genes Associated with COVID-19 in Cardiomyocytes and Cardiac Vascular Endothelial Cells. Life (Basel) 2023; 13:life13041011. [PMID: 37109540 PMCID: PMC10146712 DOI: 10.3390/life13041011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Revised: 04/02/2023] [Accepted: 04/08/2023] [Indexed: 04/29/2023] Open
Abstract
Corona Virus Disease 2019 (COVID-19) not only causes respiratory system damage, but also imposes strain on the cardiovascular system. Vascular endothelial cells and cardiomyocytes play an important role in cardiac function. The aberrant expression of genes in vascular endothelial cells and cardiomyocytes can lead to cardiovascular diseases. In this study, we sought to explain the influence of respiratory syndrome coronavirus 2 (SARS-CoV-2) infection on the gene expression levels of vascular endothelial cells and cardiomyocytes. We designed an advanced machine learning-based workflow to analyze the gene expression profile data of vascular endothelial cells and cardiomyocytes from patients with COVID-19 and healthy controls. An incremental feature selection method with a decision tree was used in building efficient classifiers and summarizing quantitative classification genes and rules. Some key genes, such as MALAT1, MT-CO1, and CD36, were extracted, which exert important effects on cardiac function, from the gene expression matrix of 104,182 cardiomyocytes, including 12,007 cells from patients with COVID-19 and 92,175 cells from healthy controls, and 22,438 vascular endothelial cells, including 10,812 cells from patients with COVID-19 and 11,626 cells from healthy controls. The findings reported in this study may provide insights into the effect of COVID-19 on cardiac cells and further explain the pathogenesis of COVID-19, and they may facilitate the identification of potential therapeutic targets.
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Affiliation(s)
- Yaochen Xu
- Department of Mathematics, School of Sciences, Shanghai University, Shanghai 200444, China
| | - Qinglan Ma
- School of Life Sciences, Shanghai University, Shanghai 200444, China
| | - Jingxin Ren
- School of Life Sciences, Shanghai University, Shanghai 200444, China
| | - Lei Chen
- College of Information Engineering, Shanghai Maritime University, Shanghai 201306, China
| | - Wei Guo
- Key Laboratory of Stem Cell Biology, Shanghai Jiao Tong University School of Medicine (SJTUSM) & Shanghai Institutes for Biological Sciences (SIBS), Chinese Academy of Sciences (CAS), Shanghai 200030, China
| | - Kaiyan Feng
- Department of Computer Science, Guangdong AIB Polytechnic College, Guangzhou 510507, China
| | - Zhenbing Zeng
- Department of Mathematics, School of Sciences, Shanghai University, Shanghai 200444, China
| | - Tao Huang
- Bio-Med Big Data Center, CAS Key Laboratory of Computational Biology, Shanghai Institute of Nutrition and Health, University of Chinese Academy of Sciences, Chinese Academy of Sciences, Shanghai 200031, China
- CAS Key Laboratory of Tissue Microenvironment and Tumor, Shanghai Institute of Nutrition and Health, University of Chinese Academy of Sciences, Chinese Academy of Sciences, Shanghai 200031, China
| | - Yudong Cai
- Department of Mathematics, School of Sciences, Shanghai University, Shanghai 200444, China
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Efficient Model for Coronary Artery Disease Diagnosis: A Comparative Study of Several Machine Learning Algorithms. JOURNAL OF HEALTHCARE ENGINEERING 2022; 2022:5359540. [PMID: 36304749 PMCID: PMC9596250 DOI: 10.1155/2022/5359540] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/21/2022] [Revised: 09/23/2022] [Accepted: 10/05/2022] [Indexed: 11/18/2022]
Abstract
Background In today's industrialized world, coronary artery disease (CAD) is one of the leading causes of death, and early detection and timely intervention can prevent many of its complications and eliminate or reduce the resulting mortality. Machine learning (ML) methods as one of the cutting-edge technologies can be used as a suitable solution in diagnosing this disease. Methods In this study, different ML algorithms' performances were compared for their effectiveness in developing a model for early CAD diagnosis based on clinical examination features. This applied descriptive study was conducted on 303 records and overall 26 features, of which 26 were selected as the target features with the advice of several clinical experts. In order to provide a diagnostic model for CAD, we ran most of the most critical classification algorithms, including Multilayer Perceptron (MLP), Support Vector Machine (SVM), Logistic Regression (LR), J48, Random Forest (RF), K-Nearest Neighborhood (KNN), and Naive Bayes (NB). Seven different classification algorithms with 26 predictive features were tested to cover all feature space and reduce model error, and the most efficient algorithms were identified by comparison of the results. Results Based on the compared performance metrics, SVM (AUC = 0.88, F-measure = 0.88, ROC = 0.85), and RF (AUC = 0.87, F-measure = 0.87, ROC = 0.91) were the most effective ML algorithms. Among the algorithms, the KNN algorithm had the lowest efficiency (AUC = 0.81, F-measure = 0.81, ROC = 0.77). In the diagnosis of coronary artery disease, machine learning algorithms have played an important role. Proposed ML models can provide practical, cost-effective, and valuable support to doctors in making decisions according to a good prediction. Discussion. It can become the basis for developing clinical decision support systems. SVM and RF algorithms had the highest efficiency and could diagnose CAD based on patient examination data. It is suggested that further studies be performed using these algorithms to diagnose coronary artery disease to obtain more accurate results.
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Du Y, Shi H, Yang X, Wu W. Machine learning for infection risk prediction in postoperative patients with non-mechanical ventilation and intravenous neurotargeted drugs. Front Neurol 2022; 13:942023. [PMID: 35979059 PMCID: PMC9376287 DOI: 10.3389/fneur.2022.942023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Accepted: 07/08/2022] [Indexed: 01/30/2023] Open
Abstract
Drug efficacy can be improved by understanding the effects of anesthesia on the neurovascular system. In this study, we used machine learning algorithms to predict the risk of infection in postoperative intensive care unit (ICU) patients who are on non-mechanical ventilation and are receiving hydromorphone analgesia. In this retrospective study, 130 patients were divided into high and low dose groups of hydromorphone analgesic pump patients admitted after surgery. The white blood cells (WBC) count and incidence rate of infection was significantly higher in the high hydromorphone dosage group compared to the low hydromorphone dosage groups (p < 0.05). Furthermore, significant differences in age (P = 0.006), body mass index (BMI) (P = 0.001), WBC count (P = 0.019), C-reactive protein (CRP) (P = 0.038), hydromorphone dosage (P = 0.014), and biological sex (P = 0.024) were seen between the infected and non-infected groups. The infected group also had a longer hospital stay and an extended stay in the intensive care unit compared to the non-infected group. We identified important risk factors for the development of postoperative infections by using machine learning algorithms, including hydromorphone dosage, age, biological sex, BMI, and WBC count. Logistic regression analysis was applied to incorporate these variables to construct infection prediction models and nomograms. The area under curves (AUC) of the model were 0.835, 0.747, and 0.818 in the training group, validation group, and overall pairwise column group, respectively. Therefore, we determined that hydromorphone dosage, age, biological sex, BMI, WBC count, and CRP are significant risk factors in developing postoperative infections.
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Pattarabanjird T, McNamara C. The clinicians' perspectives on machine learning. NATURE CARDIOVASCULAR RESEARCH 2022; 1:189-190. [PMID: 39195980 DOI: 10.1038/s44161-022-00033-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/29/2024]
Affiliation(s)
- Tanyaporn Pattarabanjird
- Carter Immunology Center, University of Virginia, Charlottesville, VA, USA
- Cardiovascular Research Center, University of Virginia, Charlottesville, VA, USA
- Department of Biomedical Engineering University of Virginia, Charlottesville, VA, USA
| | - Coleen McNamara
- Carter Immunology Center, University of Virginia, Charlottesville, VA, USA.
- Cardiovascular Research Center, University of Virginia, Charlottesville, VA, USA.
- Division of Cardiovascular Medicine/Department of Medicine, University of Virginia, Charlottesville, VA, USA.
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Suri JS, Bhagawati M, Paul S, Protogeron A, Sfikakis PP, Kitas GD, Khanna NN, Ruzsa Z, Sharma AM, Saxena S, Faa G, Paraskevas KI, Laird JR, Johri AM, Saba L, Kalra M. Understanding the bias in machine learning systems for cardiovascular disease risk assessment: The first of its kind review. Comput Biol Med 2022; 142:105204. [DOI: 10.1016/j.compbiomed.2021.105204] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2021] [Revised: 12/29/2021] [Accepted: 12/29/2021] [Indexed: 02/09/2023]
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Current and Future Applications of Artificial Intelligence in Coronary Artery Disease. Healthcare (Basel) 2022; 10:healthcare10020232. [PMID: 35206847 PMCID: PMC8872080 DOI: 10.3390/healthcare10020232] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 01/19/2022] [Accepted: 01/24/2022] [Indexed: 02/07/2023] Open
Abstract
Cardiovascular diseases (CVDs) carry significant morbidity and mortality and are associated with substantial economic burden on healthcare systems around the world. Coronary artery disease, as one disease entity under the CVDs umbrella, had a prevalence of 7.2% among adults in the United States and incurred a financial burden of 360 billion US dollars in the years 2016–2017. The introduction of artificial intelligence (AI) and machine learning over the last two decades has unlocked new dimensions in the field of cardiovascular medicine. From automatic interpretations of heart rhythm disorders via smartwatches, to assisting in complex decision-making, AI has quickly expanded its realms in medicine and has demonstrated itself as a promising tool in helping clinicians guide treatment decisions. Understanding complex genetic interactions and developing clinical risk prediction models, advanced cardiac imaging, and improving mortality outcomes are just a few areas where AI has been applied in the domain of coronary artery disease. Through this review, we sought to summarize the advances in AI relating to coronary artery disease, current limitations, and future perspectives.
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