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.