Accuracy of Machine Learning Models for Early Prediction of Major Cardiovascular Events Post Myocardial Infarction: A Systematic Review and Meta-Analysis

Background: Major adverse cardiovascular events (MACEs) significantly affect the prognosis of patients with myocardial infarction (MI). With the widespread application of machine learning (ML), researchers have attempted to develop models for predicting MACEs following MI. However...

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Main Authors: Yi Xiang, Dong Liu, Leilei Guo, Yuhua Zheng, Xiaoman Xiong, Tao Xu
Format: Article
Language:English
Published: IMR Press 2025-06-01
Series:Reviews in Cardiovascular Medicine
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Online Access:https://www.imrpress.com/journal/RCM/26/6/10.31083/RCM37224
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author Yi Xiang
Dong Liu
Leilei Guo
Yuhua Zheng
Xiaoman Xiong
Tao Xu
author_facet Yi Xiang
Dong Liu
Leilei Guo
Yuhua Zheng
Xiaoman Xiong
Tao Xu
author_sort Yi Xiang
collection DOAJ
description Background: Major adverse cardiovascular events (MACEs) significantly affect the prognosis of patients with myocardial infarction (MI). With the widespread application of machine learning (ML), researchers have attempted to develop models for predicting MACEs following MI. However, there remains a lack of evidence-based proof to validate their value. Thus, we conducted this study to review the ML models’ performance in predicting MACEs following MI, contributing to the evidence base for the application of clinical prediction tools. Methods: A systematic literature search spanned four major databases (Cochrane, Embase, PubMed, Web of Science) with entries through to June 19, 2024. With the Prediction Model Risk of Bias Assessment Tool (PROBAST), the risk of bias in the included models was appraised. Subgroup analyses based on whether patients had percutaneous coronary intervention (PCI) were carried out for the analysis. Results: Twenty-eight studies were included for analysis, covering 59,392 patients with MI. The pooled C-index for ML models in the validation sets was 0.77 (95% CI 0.74–0.81) in predicting MACEs post MI, with a sensitivity (SEN) and specificity (SPE) of 0.78 (95% CI 0.73–0.82) and 0.85 (95% CI 0.81–0.89), respectively; the pooled C-index was 0.73 (95% CI 0.66–0.79) in the validation sets, with an SEN of 0.75 (95% CI 0.67–0.81) and an SPE of 0.84 (95% CI 0.75–0.90) in patients who underwent PCI. Logistic regression was the predominant model in the studies and demonstrated relatively high accuracy. Conclusions: ML models based on clinical characteristics following MI, influence the accuracy of prediction. Therefore, future studies can include larger sample sizes and develop simplified tools for predicting MACEs. The PROSPERO registration: CRD42024564550, https://www.crd.york.ac.uk/PROSPERO/view/CRD42024564550.
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spelling doaj-art-6fcc2a364c944e00a1909d2348e843b82025-08-20T03:29:48ZengIMR PressReviews in Cardiovascular Medicine1530-65502025-06-012663722410.31083/RCM37224S1530-6550(25)01869-1Accuracy of Machine Learning Models for Early Prediction of Major Cardiovascular Events Post Myocardial Infarction: A Systematic Review and Meta-AnalysisYi Xiang0Dong Liu1Leilei Guo2Yuhua Zheng3Xiaoman Xiong4Tao Xu5School of Postgraduate Students, Guizhou University of Traditional Chinese Medicine, 550000 Guiyang, Guizhou, ChinaSchool of Medicine, Guizhou University of Traditional Chinese Medicine, 550000 Guiyang, Guizhou, ChinaCardiovascular Medicine, The Second Affiliated Hospital of Guizhou University of Traditional Chinese Medicine, 550000 Guiyang, Guizhou, ChinaSchool of Postgraduate Students, Guizhou University of Traditional Chinese Medicine, 550000 Guiyang, Guizhou, ChinaSchool of Postgraduate Students, Guizhou University of Traditional Chinese Medicine, 550000 Guiyang, Guizhou, ChinaCardiovascular Medicine, The Second Affiliated Hospital of Guizhou University of Traditional Chinese Medicine, 550000 Guiyang, Guizhou, ChinaBackground: Major adverse cardiovascular events (MACEs) significantly affect the prognosis of patients with myocardial infarction (MI). With the widespread application of machine learning (ML), researchers have attempted to develop models for predicting MACEs following MI. However, there remains a lack of evidence-based proof to validate their value. Thus, we conducted this study to review the ML models’ performance in predicting MACEs following MI, contributing to the evidence base for the application of clinical prediction tools. Methods: A systematic literature search spanned four major databases (Cochrane, Embase, PubMed, Web of Science) with entries through to June 19, 2024. With the Prediction Model Risk of Bias Assessment Tool (PROBAST), the risk of bias in the included models was appraised. Subgroup analyses based on whether patients had percutaneous coronary intervention (PCI) were carried out for the analysis. Results: Twenty-eight studies were included for analysis, covering 59,392 patients with MI. The pooled C-index for ML models in the validation sets was 0.77 (95% CI 0.74–0.81) in predicting MACEs post MI, with a sensitivity (SEN) and specificity (SPE) of 0.78 (95% CI 0.73–0.82) and 0.85 (95% CI 0.81–0.89), respectively; the pooled C-index was 0.73 (95% CI 0.66–0.79) in the validation sets, with an SEN of 0.75 (95% CI 0.67–0.81) and an SPE of 0.84 (95% CI 0.75–0.90) in patients who underwent PCI. Logistic regression was the predominant model in the studies and demonstrated relatively high accuracy. Conclusions: ML models based on clinical characteristics following MI, influence the accuracy of prediction. Therefore, future studies can include larger sample sizes and develop simplified tools for predicting MACEs. The PROSPERO registration: CRD42024564550, https://www.crd.york.ac.uk/PROSPERO/view/CRD42024564550.https://www.imrpress.com/journal/RCM/26/6/10.31083/RCM37224myocardial infarctionmachine learningmacespci
spellingShingle Yi Xiang
Dong Liu
Leilei Guo
Yuhua Zheng
Xiaoman Xiong
Tao Xu
Accuracy of Machine Learning Models for Early Prediction of Major Cardiovascular Events Post Myocardial Infarction: A Systematic Review and Meta-Analysis
Reviews in Cardiovascular Medicine
myocardial infarction
machine learning
maces
pci
title Accuracy of Machine Learning Models for Early Prediction of Major Cardiovascular Events Post Myocardial Infarction: A Systematic Review and Meta-Analysis
title_full Accuracy of Machine Learning Models for Early Prediction of Major Cardiovascular Events Post Myocardial Infarction: A Systematic Review and Meta-Analysis
title_fullStr Accuracy of Machine Learning Models for Early Prediction of Major Cardiovascular Events Post Myocardial Infarction: A Systematic Review and Meta-Analysis
title_full_unstemmed Accuracy of Machine Learning Models for Early Prediction of Major Cardiovascular Events Post Myocardial Infarction: A Systematic Review and Meta-Analysis
title_short Accuracy of Machine Learning Models for Early Prediction of Major Cardiovascular Events Post Myocardial Infarction: A Systematic Review and Meta-Analysis
title_sort accuracy of machine learning models for early prediction of major cardiovascular events post myocardial infarction a systematic review and meta analysis
topic myocardial infarction
machine learning
maces
pci
url https://www.imrpress.com/journal/RCM/26/6/10.31083/RCM37224
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