Brazilian Cohort for Predicting Cardiovascular Events Using Machine Learning (PRE-CARE ML project)

The project PRE-CARE ML addresses the development and internal and external validation of predictive models for the assessment of risks of major adverse cardiovascular events. Global and local interpretability analyses of predictions were conducted towards improving model reliability and tailoring preventive interventions. The models were trained and validated in a retrospective cohort with the use of data from Hospital das Clínicas da Faculdade de Medicina de Ribeirao Preto, Brazil The International Classification of Diseases (ICD-10) classified patients with MACE (case group). (see Table I for the ICD-10 codes that defined MACE). Table 1: ICD-10 Codees for MACE definition ICD-10 Description I20 Angina pectoris I21 Acute myocardial infarction I24 Other acute ischaemic heart diseases I46 Cardiac arrest I63 Cerebral infarction I64 Stroke, not specified as hemorrhage or infarction I71 Aortic aneurysm and dissection I74 Arterial embolism and thrombosis Only a patient’s first MACE was considered, and all previous hospitalizations within a 5-year window were considered MACE. The control group (non-MACE) involved hospitalizations with no MACE and no death within a 5-year window (between 2017 and 2022). A sample of 6,000 MACE (labeled as 1) cases and 12,000 non-MACE (labeled as 0) ones was constructed with data from HCFMRP for training and internal validation purposes. Another balanced MIMIC IV sample of 8,000 MACE cases and 8,000 nonMACE cases was used for external validation.