Coronary heart disease (CHD) is a leading cause of death worldwide and contributes significantly to annual healthcare expenditures. To develop a non-invasive diagnostic approach, we designed a model based on a multilayer perceptron (MLP) neural network, trained on 50 key urinary peptide biomarkers selected via genetic algorithms. Treatment and control groups, each comprising 345 individuals, were balanced using the Synthetic Minority Over-sampling Technique (SMOTE). The neural network was trained using a stratified validation strategy. Using a network with three hidden layers of 60 neurons each and an output layer of two neurons, the model achieved a precision, sensitivity, and specificity of 95.67 percent, with an F1-score of 0.9565. The area under the ROC curve (AUC) reached 0.9748 for both classes, while the Matthews correlation coefficient (MCC) and Cohen's kappa coefficient were 0.9134 and 0.9131, respectively, demonstrating its reliability in detecting CHD. These results indicate that the model provides a highly accurate and robust non-invasive diagnostic tool for coronary heart disease.

Patient similarity computation (PSC) is a fundamental problem in healthcare informatics. The aim of the patient similarity computation is to measure the similarity among patients according to their historical clinical records, which helps to improve clinical decision support. This paper presents a novel distributed patient similarity computation (DPSC) technique based on data transformation (DT) methods, utilizing an effective combination of time series and static data. Time series data are sensor-collected patients' information, including metrics like heart rate, blood pressure, Oxygen saturation, respiration, etc. The static data are mainly patient background and demographic data, including age, weight, height, gender, etc. Static data has been used for clustering the patients. Before feeding the static data to the machine learning model adaptive Weight-of-Evidence (aWOE) and Z-score data transformation (DT) methods have been performed, which improve the prediction performances. In aWOE-based patient similarity models, sensitive patient information has been processed using aWOE which preserves the data privacy of the trained models. We used the Dynamic Time Warping (DTW) approach, which is robust and very popular, for time series similarity. However, DTW is not suitable for big data due to the significant computational run-time. To overcome this problem, distributed DTW computation is used in this study. For Coronary Artery Disease, our DT based approach boosts prediction performance by as much as 11.4%, 10.20%, and 12.6% in terms of AUC, accuracy, and F-measure, respectively. In the case of Congestive Heart Failure (CHF), our proposed method achieves performance enhancement up to 15.9%, 10.5%, and 21.9% for the same measures, respectively. The proposed method reduces the computation time by as high as 40%.

Premature coronary artery disease (PCAD) refers to the early onset of the disease, usually before the age of 55 for men and 65 for women. Coronary Artery Disease (CAD) develops when coronary arteries, the major blood vessels supplying the heart with blood, oxygen, and nutrients, become clogged or diseased. This is often due to many risk factors, including lifestyle and cardiometabolic ones, but few studies were done on ethnicity as one of these risk factors, especially in PCAD. In this study, we tested the rank of ethnicity among the major risk factors of PCAD, including age, gender, body mass index (BMI), visceral obesity presented as waist circumference (WC), diabetes mellitus (DM), high blood pressure (HBP), high low-density lipoprotein cholesterol (LDL-C), and smoking in a large national sample of patients with PCAD from different ethnicities. All patients who met the age criteria underwent coronary angiography to confirm CAD diagnosis. The weight of ethnicity was compared to the other eight features using feature weighting algorithms in PCAD diagnosis. In addition, we conducted an experiment where we ran predictive models (classification algorithms) to predict PCAD. We compared the performance of these models under two conditions: we trained the classification algorithms, including or excluding ethnicity. This study analyzed various factors to determine their predictive power influencing PCAD prediction. Among these factors, gender and age were the most significant predictors, with ethnicity being the third most important. The results also showed that if ethnicity is used as one of the input risk factors for classification algorithms, it can improve their efficiency. Our results show that ethnicity ranks as an influential factor in predicting PCAD. Therefore, it needs to be addressed in the PCAD diagnostic and preventive measures.

Abstract: Background: Understanding cardiovascular artery disease risk factors, the leading global cause of mortality, is crucial for influencing its etiology, prevalence, and treatment. This study aims to evaluate prognostic markers for coronary artery disease in Mashhad using Naive Bayes, REP Tree, J48, CART, and CHAID algorithms. Methods: Using data from the 2009 MASHAD STUDY, prognostic factors for coronary artery disease were determined with Naive Bayes, REP Tree, J48, CART, CHAID, and Random Forest algorithms using R 3.5.3 and WEKA 3.9.4. Model efficiency was compared by sensitivity, specificity, and accuracy. Cases were patients with coronary artery disease; each had three controls (totally 940). Results: Prognostic factors for coronary artery disease in Mashhad residents varied by algorithm. CHAID identified age, myocardial infarction history, and hypertension. CART included depression score and physical activity. REP added education level and anxiety score. NB included diabetes and family history. J48 highlighted father's heart disease and weight loss. CHAID had the highest accuracy (0.80). Conclusion: Key prognostic factors for coronary artery disease in CART and CHAID models include age, myocardial infarction history, hypertension, depression score, physical activity, and BMI. NB, REP Tree, and J48 identified numerous factors. CHAID had the highest accuracy, sensitivity, and specificity. CART offers simpler interpretation, aiding physician and paramedic model selection based on specific. Keywords: RF, Na\"ive Bayes, REP, J48 algorithms, Coronary Artery Disease (CAD).

Machine learning models have the potential to identify cardiovascular diseases (CVDs) early and accurately in primary healthcare settings, which is crucial for delivering timely treatment and management. Although population-based CVD risk models have been used traditionally, these models often do not consider variations in lifestyles, socioeconomic conditions, or genetic predispositions. Therefore, we aimed to develop machine learning models for CVD detection using primary healthcare data, compare the performance of different models, and identify the best models. We used data from the UK Biobank study, which included over 500,000 middle-aged participants from different primary healthcare centers in the UK. Data collected at baseline (2006--2010) and during imaging visits after 2014 were used in this study. Baseline characteristics, including sex, age, and the Townsend Deprivation Index, were included. Participants were classified as having CVD if they reported at least one of the following conditions: heart attack, angina, stroke, or high blood pressure. Cardiac imaging data such as electrocardiogram and echocardiography data, including left ventricular size and function, cardiac output, and stroke volume, were also used. We used 9 machine learning models (LSVM, RBFSVM, GP, DT, RF, NN, AdaBoost, NB, and QDA), which are explainable and easily interpretable. We reported the accuracy, precision, recall, and F-1 scores; confusion matrices; and area under the curve (AUC) curves.

With the universal adoption of machine learning in healthcare, the potential for the automation of societal biases to further exacerbate health disparities poses a significant risk. We explore algorithmic fairness from the perspective of feature selection. Traditional feature selection methods identify features for better decision making by removing resource-intensive, correlated, or non-relevant features but overlook how these factors may differ across subgroups. To counter these issues, we evaluate a fair feature selection method that considers equal importance to all demographic groups. We jointly considered a fairness metric and an error metric within the feature selection process to ensure a balance between minimizing both bias and global classification error. We tested our approach on three publicly available healthcare datasets. On all three datasets, we observed improvements in fairness metrics coupled with a minimal degradation of balanced accuracy. Our approach addresses both distributive and procedural fairness within the fair machine learning context.

Department of Radiology, Case Western Reserve University, Cleveland, OH, 44106, USA Abstract Background: Recent studies have used basic epicardial adipose tissue (EAT) assessments (e.g., volume and mean HU) to predict risk of atherosclerosis-related, major adverse cardiovascular events (MACE). Objectives: Create novel, hand-crafted EAT features, "fat-omics", to capture the pathophysiology of EAT and improve MACE prediction. We extracted 148 radiomic features (morphological, spatial, and intensity) and used Cox elastic-net for feature reduction and prediction of MACE. Results: Traditional fat features gave marginal prediction (EAT-volume/EAT-mean-HU/ BMI gave C-index 0.53/0.55/0.57, Significant improvement was obtained with 15 fat-omics features (C-index=0.69, Other high-risk features include kurtosis-of-EAT-thickness, reflecting the heterogeneity of thicknesses, and EATvolume-in-the-top-25%-of-the-heart, emphasizing adipose near the proximal coronary arteries. Kaplan-Meyer plots of Cox-identified, high-and low-risk patients were well separated with the median of the fat-omics risk, while high-risk group having HR 2.4 times that of the low-risk group (P<0.001). Conclusion: Preliminary findings indicate an opportunity to use more finely tuned, explainable assessments on EAT for improved cardiovascular risk prediction. Introduction Cardiovascular disease is a major cause of morbidity and mortality worldwide (1), leading to 17.9 million deaths globally each year (2). Numerous risk score methodologies have been developed to predict risks from cardiovascular disease, but these methods often lack sufficient discrimination (3). Accurate explainable risk prediction models will provide useful information to patients and physicians for more personalized medications and interventions. Previous studies have determined the usefulness of coronary calcification Agatston score as obtained from CT calcium score (CTCS) images for cardiovascular risk prediction.

In the era of digital medicine, medical imaging serves as a widespread technique for early disease detection, with a substantial volume of images being generated and stored daily in electronic patient records. X-ray angiography imaging is a standard and one of the most common methods for rapidly diagnosing coronary artery diseases. The notable achievements of recent deep learning algorithms align with the increased use of electronic health records and diagnostic imaging. Deep neural networks, leveraging abundant data, advanced algorithms, and powerful computational capabilities, prove highly effective in the analysis and interpretation of images. In this context, Object detection methods have become a promising approach, particularly through convolutional neural networks (CNN), streamlining medical image analysis by eliminating manual feature extraction. This allows for direct feature extraction from images, ensuring high accuracy in results. Therefore, in our paper, we utilized the object detection method on X-ray angiography images to precisely identify the location of coronary artery stenosis. As a result, this model enables automatic and real-time detection of stenosis locations, assisting in the crucial and sensitive decision-making process for healthcare professionals.

Accurate segmentation of coronary arteries is a pivotal process in assessing cardiovascular diseases. However, the intricate structure of the cardiovascular system presents significant challenges for automatic segmentation, especially when utilizing methodologies like the SYNTAX Score, which relies extensively on detailed structural information for precise risk stratification. To address these difficulties and cater to this need, we present MPSeg, an innovative multi-phase strategy designed for coronary artery segmentation. Our approach specifically accommodates these structural complexities and adheres to the principles of the SYNTAX Score. Initially, our method segregates vessels into two categories based on their unique morphological characteristics: Left Coronary Artery (LCA) and Right Coronary Artery (RCA). Specialized ensemble models are then deployed for each category to execute the challenging segmentation task. Due to LCA's higher complexity over RCA, a refinement model is utilized to scrutinize and correct initial class predictions on segmented areas. Notably, our approach demonstrated exceptional effectiveness when evaluated in the Automatic Region-based Coronary Artery Disease diagnostics using x-ray angiography imagEs (ARCADE) Segmentation Detection Algorithm challenge at MICCAI 2023.

Corresponding author: Dr Joseph Jacob UCL Centre for Medical Image Computing 1st Floor, 90 High Holborn, London WC1V6LJ j.jacob@ucl.ac.uk Abstract Early detection and diagnosis of coronary artery disease (CAD) could save lives and reduce healthcare costs. In this study, we propose a 3D Resnet-50 deep learning model to directly classify normal subjects and CAD patients on computed tomography coronary angiography images. Our proposed method outperforms a 2D Resnet-50 model by 23.65%. Explainability is also provided by using a Grad-GAM. Furthermore, we link the 3D CAD classification to a 2D two-class semantic segmentation for improved explainability and accurate abnormality localisation. Introduction Coronary artery disease (CAD) is a common cause of death [1] in developed (i.e., UK, USA) and developing countries (i.e., India, Philippines). Early detection and diagnosis of CAD could save lives and costs [2]. Currently, computed tomography coronary angiography (CTCA) plays a central role in diagnosing or excluding CAD in patients with chest pain [3, 4].