Machine learning in cardiovascular risk assessment: Towards a precision medicine approach.

Journal: European journal of clinical investigation
PMID:

Abstract

Cardiovascular diseases remain the leading cause of global morbidity and mortality. Validated risk scores are the basis of guideline-recommended care, but most scores lack the capacity to integrate complex and multidimensional data. Limitations inherent to traditional risk prediction models and the growing burden of residual cardiovascular risk highlight the need for refined strategies that go beyond conventional paradigms. Artificial intelligence and machine learning (ML) provide unique opportunities to refine cardiovascular risk assessment and surveillance through the integration of diverse data types and sources, including clinical, electrocardiographic, imaging and multi-omics derived data. In fact, ML models, such as deep neural networks, can handle high-dimensional data through which phenotyping and cardiovascular risk assessment across diverse patient populations become much more precise, fostering a paradigm shift towards more personalized care. Here, we review the role of ML in advancing cardiovascular risk assessment and discuss its potential to identify novel therapeutic targets and to improve prevention strategies. We also discuss key challenges inherent to ML, such as data quality, standardized reporting, model transparency and validation, and discuss barriers in its clinical translation. We highlight the transformative potential of ML in precision cardiology and advocate for more personalized cardiovascular prevention strategies that go beyond previous notions.

Authors

  • Yifan Wang
    School of Bioscience and Bioengineering, South China University of Technology, Guangzhou, China.
  • Evmorfia Aivalioti
    Department of Clinical Therapeutics, Alexandra Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece.
  • Kimon Stamatelopoulos
    Department of Clinical Therapeutics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece.
  • Georgios Zervas
    Department of Clinical Therapeutics, Alexandra Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece.
  • Martin Bødtker Mortensen
    Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark.
  • Marianne Zeller
    Department of Cardiology, CHU Dijon Bourgogne, Dijon, France.
  • Luca Liberale
    Department of Internal Medicine, University of Genoa, 6 viale Benedetto XV, 16132 Genoa, Italy; IRCCS Ospedale Policlinico San Martino, Genoa - Italian Cardiovascular Network, Largo Rosanna Benzi 10, 16132, Genoa, Italy.
  • Davide Di Vece
    First Clinic of Internal Medicine, Department of Internal Medicine, University of Genoa, Genoa, Italy.
  • Victor Schweiger
    Deutsches Herzzentrum der Charité Campus Virchow-Klinikum, Berlin, Germany.
  • Giovanni G Camici
    Center for Molecular Cardiology, University of Zurich, Schlieren, Switzerland.
  • Thomas F Lüscher
    Royal Brompton & Harefield Hospitals, Imperial College1, London, UK.
  • Simon Kraler
    Center for Molecular Cardiology, University of Zurich, Schlieren, Switzerland.