Machine learning approaches that use clinical, laboratory, and electrocardiogram data enhance the prediction of obstructive coronary artery disease

• Published in: Scientific reports Vol. 13; no. 1; p. 12635
• Main Authors: Lee, Hyun-Gyu, Park, Sang-Don, Bae, Jang-Whan, Moon, SungJoon, Jung, Chai Young, Kim, Mi-Sook, Kim, Tae-Hun, Lee, Won Kyung
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 03.08.2023; Nature Publishing Group; Nature Portfolio
• Subjects: 692/308/575; 692/699/75; Algorithms; Angiography; Cardiovascular disease; Coronary artery disease; Coronary vessels; Deep learning; EKG; Electrocardiography; Electronic medical records; Heart diseases; Humanities and Social Sciences; Laboratories; Learning algorithms; Machine learning; multidisciplinary; Patients; Science; Science (multidisciplinary); Vein & artery diseases
• ISSN: 2045-2322; 2045-2322
• DOI: 10.1038/s41598-023-39911-y

Pretest probability (PTP) for assessing obstructive coronary artery disease (ObCAD) was updated to reduce overestimation. However, standard laboratory findings and electrocardiogram (ECG) raw data as first-line tests have not been evaluated for integration into the PTP estimation. Therefore, this study developed an ensemble model by adopting machine learning (ML) and deep learning (DL) algorithms with clinical, laboratory, and ECG data for the assessment of ObCAD. Data were extracted from the electronic medical records of patients with suspected ObCAD who underwent coronary angiography. With the ML algorithm, 27 clinical and laboratory data were included to identify ObCAD, whereas ECG waveform data were utilized with the DL algorithm. The ensemble method combined the clinical-laboratory and ECG models. We included 7907 patients between 2008 and 2020. The clinical and laboratory model showed an area under the curve (AUC) of 0.747; the ECG model had an AUC of 0.685. The ensemble model demonstrated the highest AUC of 0.767. The sensitivity, specificity, and F1 score of the ensemble model ObCAD were 0.761, 0.625, and 0.696, respectively. It demonstrated good performance and superior prediction over traditional PTP models. This may facilitate personalized decisions for ObCAD assessment and reduce PTP overestimation.