Cardiovascular disease detection using machine learning and carotid/femoral arterial imaging frameworks in rheumatoid arthritis patients.

Journal: Rheumatology international
PMID:

Abstract

The study proposes a novel machine learning (ML) paradigm for cardiovascular disease (CVD) detection in individuals at medium to high cardiovascular risk using data from a Greek cohort of 542 individuals with rheumatoid arthritis, or diabetes mellitus, and/or arterial hypertension, using conventional or office-based, laboratory-based blood biomarkers and carotid/femoral ultrasound image-based phenotypes. Two kinds of data (CVD risk factors and presence of CVD-defined as stroke, or myocardial infarction, or coronary artery syndrome, or peripheral artery disease, or coronary heart disease) as ground truth, were collected at two-time points: (i) at visit 1 and (ii) at visit 2 after 3 years. The CVD risk factors were divided into three clusters (conventional or office-based, laboratory-based blood biomarkers, carotid ultrasound image-based phenotypes) to study their effect on the ML classifiers. Three kinds of ML classifiers (Random Forest, Support Vector Machine, and Linear Discriminant Analysis) were applied in a two-fold cross-validation framework using the data augmented by synthetic minority over-sampling technique (SMOTE) strategy. The performance of the ML classifiers was recorded. In this cohort with overall 46 CVD risk factors (covariates) implemented in an online cardiovascular framework, that requires calculation time less than 1 s per patient, a mean accuracy and area-under-the-curve (AUC) of 98.40% and 0.98 (p < 0.0001) for CVD presence detection at visit 1, and 98.39% and 0.98 (p < 0.0001) at visit 2, respectively. The performance of the cardiovascular framework was significantly better than the classical CVD risk score. The ML paradigm proved to be powerful for CVD prediction in individuals at medium to high cardiovascular risk.

Authors

  • George Konstantonis
    Rheumatology Unit, National Kapodistrian University of Athens, Athens, Greece.
  • Krishna V Singh
    Research Intern, AtheroPoint™, Roseville, CA, USA.
  • Petros P Sfikakis
    1st Department of Propaedeutic Internal Medicine, Medical School, National and Kapodistrian University of Athens, Athens, Greece.
  • Ankush D Jamthikar
    Department of Electronics and Communication Engineering, Visvesvaraya National Institute of Technology, Nagpur, Maharashtra, India.
  • George D Kitas
    Arthritis Research UK Centre for Epidemiology, Manchester University, Manchester, UK.
  • Suneet K Gupta
    Department of Computer Science Engineering, Bennett University, India.
  • Luca Saba
    Department of Radiology, A.O.U., Italy.
  • Kleio Verrou
    Department of Medicine, National and Kapodistrian University of Athens, Athens, Greece.
  • Narendra N Khanna
    Cardiology Department, Apollo Hospitals, New Delhi, India.
  • Zoltan Ruzsa
    Department of Internal Medicines, Invasive Cardiology Division, University of Szeged, Szeged, Hungary.
  • Aditya M Sharma
    Cardiovascular Medicine, University of Virginia, Charlottesville, VA, USA.
  • John R Laird
    UC Davis Vascular Center, University of California, Davis, CA, USA.
  • Amer M Johri
    Division of Cardiology, Department of Medicine, Queen's University, Kingston, ON, Canada.
  • Manudeep Kalra
    Department of Radiology, Massachusetts General Hospital, 55 Fruit Street, Boston, MA, USA.
  • Athanasios Protogerou
    Department of Cardiovascular Prevention & Research Unit Clinic & Laboratory of Pathophysiology, National and Kapodistrian Univ. of Athens, Greece.
  • Jasjit S Suri
    Advanced Knowledge Engineering Center, Global Biomedical Technologies, Inc., Roseville, CA, USA. Electronic address: jsuri@comcast.net.