Cardiovascular risk prediction – are we missing something?

An efficient cardiovascular disease prediction model through AI-driven IoT technology

Conditions affecting the circulatory system and blood vessels are referred to as cardiovascular diseases that include strokes and heart attacks. Internet of Things (IoT) technologies monitor health metrics, identify irregularities and enable remote patient care, resulting in earlier intervention and more individualized therapy. This research aims to establish an efficient cardiovascular disease prediction model through Artificial intelligence (AI)-driven IoT technology. We propose a novel Shuffled Frog leaping-tuned Iterative Improved Adaptive Boosting (SF-IIAdaboost) algorithm for predicting cardiovascular disease with the implementation of IoT device data. IoT medical sensors and wearable devices will collect the patient's clinical data in our proposed framework. Z-score normalization is used to preprocess the gathered data and optimize its quality. Kernel principal component analysis (Kernel-PCA) extracts the relevant features from the processed data. We obtained a dataset that contains various health data gathered from numerous sensing devices to train our recommended model. Our proposed methodology is implemented using Python software. During the evaluation phase, we assess the effectiveness of our model across different parameters. We conduct comparative analyses against conventional methods to ascertain the superiority of our approach. Experimental findings demonstrate the superior performance of our recognition method over traditional approaches. The proposed SF-IIAdaboost algorithm, integrated with IoT device data, presents a promising avenue for predicting cardiovascular disease. The SF-IIAdaboost model demonstrated notable enhancements, attaining 95.37 % accuracy, 93.51 % precision, 94.3 % sensitivity, 96.31 % specificity, and 95.72 % F-measure. Future developments are predicted to involve computing on the edge, where immediate evaluations can be performed in the edge layer to avoid the basic constraints of the clouds, such as high latency, utilization of bandwidth and performing the growth of IoT data. Edge computing can revolutionize the healthcare industry's efficacy by enabling providers to make flexible decisions, operate quickly, and accurately anticipate diseases. It can improve the average level of service standards.

External validation and extension of the TIMI risk score for heart failure in diabetes for patients with recent acute coronary syndrome: An analysis of the EXAMINE trial

AIMS

The Thrombolysis in Myocardial Infarction Risk Score for Heart Failure (HF) in Diabetes (TRS-HF_DM ) prognosticates HF hospitalization in people with type 2 diabetes (T2D). This study aimed to externally validate and extend its use for those with recent acute coronary syndrome (ACS).

MATERIALS AND METHODS

The TRS-HF_DM was externally validated in the Examination of Cardiovascular Outcomes with Alogliptin versus Standard of Care (EXAMINE) trial (n = 5380) and extended with natriuretic biomarkers. Missing data were multiply imputed. Initial TRS-HF_DM variables were previous HF (2 points), atrial fibrillation (1 point), coronary artery disease (1 point), estimated glomerular filtration rate <60 ml/min/1.73 m² (1 point), and urine albumin-to-creatinine ratio 30-300 mg/g (1 point) and >300 mg/g (2 points).

RESULTS

In total, HF hospitalization occurred in 193 (3.6%) patients. Based on the TRS-HF_DM , 25% of patients were classified as intermediate risk (1 point), 30% were classified as high risk (2 points), 19% were classified as very-high risk (3 points) and 26% were classified as severe risk (≥4 points). Before model extension, discrimination (C-index 0.76, 95%·CI 0.73-0.80) and calibration (calibration slope 0.82, 95%·CI 0.65-1.0; calibration-in-the-large -0.15, 95%·CI -0.37-0.64) were moderate-to-good in individuals with T2D and recent ACS. The extension of TRS-HF_DM with the addition of N-terminal pro-B-type natriuretic peptide (NT-ProBNP) improved discrimination (C-index 0.82, 95%·CI 0.79-0.85) and calibration (calibration slope 0.84, 95%·CI 0.66-1.02; calibration-in-the-large -0.12, 95%·CI -0.33-0.081) for this higher-risk population.

CONCLUSION

The TRS-HF_DM with the extension of NT-ProBNP improves risk stratification and generalizes the use of the risk score for patients with T2D and ACS. Future validation studies in ACS populations may be warranted.