Machine learning-based prediction of in-hospital death for patients with takotsubo syndrome: The InterTAK-ML model.

Autor:	De Filippo O; Division of Cardiology, Department of Medical Sciences, AOU Città della Salute e della Scienza, University of Turin, Turin, Italy., Cammann VL; Department of Cardiology, University Heart Center, University Hospital Zurich, and University of Zurich, Zurich, Switzerland., Pancotti C; Department of Medical Sciences, University of Turin, Turin, Italy., Di Vece D; Department of Cardiology, University Heart Center, University Hospital Zurich, and University of Zurich, Zurich, Switzerland., Silverio A; Department of Medicine, Surgery and Dentistry, University of Salerno, Baronissi, Italy., Schweiger V; Department of Cardiology, University Heart Center, University Hospital Zurich, and University of Zurich, Zurich, Switzerland., Niederseer D; Department of Cardiology, University Heart Center, University Hospital Zurich, and University of Zurich, Zurich, Switzerland., Szawan KA; Department of Cardiology, University Heart Center, University Hospital Zurich, and University of Zurich, Zurich, Switzerland., Würdinger M; Department of Cardiology, University Heart Center, University Hospital Zurich, and University of Zurich, Zurich, Switzerland., Koleva I; Department of Cardiology, University Heart Center, University Hospital Zurich, and University of Zurich, Zurich, Switzerland., Dusi V; Division of Cardiology, Department of Medical Sciences, AOU Città della Salute e della Scienza, University of Turin, Turin, Italy., Bellino M; Department of Medicine, Surgery and Dentistry, University of Salerno, Baronissi, Italy., Vecchione C; Department of Medicine, Surgery and Dentistry, University of Salerno, Baronissi, Italy.; Department of Vascular Physiopathology, IRCCS Neuromed, Pozzilli, Italy., Parodi G; Department of Medicine, Surgery and Pharmacy, University of Sassari, Sassari, Italy., Bossone E; Division of Cardiology, 'Antonio Cardarelli' Hospital, Naples, Italy., Gili S; Centro Cardiologico Monzino, IRCCS, Milan, Italy., Neuhaus M; Department of Cardiology, Kantonsspital Frauenfeld, Frauenfeld, Switzerland., Franke J; Department of Cardiology, Heidelberg University Hospital, Heidelberg, Germany., Meder B; Department of Cardiology, Heidelberg University Hospital, Heidelberg, Germany., Jaguszewski M; First Department of Cardiology, Medical University of Gdansk, Gdansk, Poland., Noutsias M; Division of Cardiology, Angiology and Intensive Medical Care, Department of Internal Medicine III, Mid-German Heart Center, University Hospital Halle, Martin-Luther-University Halle-Wittenberg, Halle (Saale), Germany., Knorr M; Center for Cardiology, Cardiology 1, University Medical Center Mainz, Mainz, Germany., Jansen T; Center for Cardiology, Cardiology 1, University Medical Center Mainz, Mainz, Germany., Dichtl W; University Hospital for Internal Medicine III (Cardiology and Angiology), Medical University Innsbruck, Innsbruck, Austria., von Lewinski D; Division of Cardiology, Medical University of Graz, Graz, Austria., Burgdorf C; Heart and Vascular Centre Bad Bevensen, Bad Bevensen, Germany., Kherad B; Department of Cardiology, Charité, Campus Rudolf Virchow, Berlin, Germany., Tschöpe C; Department of Cardiology, Charité, Campus Rudolf Virchow, Berlin, Germany., Sarcon A; Section of Cardiac Electrophysiology, Department of Medicine, University of California, San Francisco, San Francisco, CA, USA., Shinbane J; Keck School of Medicine, University of Southern California, Los Angeles, CA, USA., Rajan L; TJ Health Partners Heart and Vascular, Glasgow, KY, USA., Michels G; Klinik für Akut- und Notfallmedizin, St.-Antonius-Hospital gGmbH, Akademisches Lehrkrankenhaus der RWTH Aachen, Eschweiler, Germany., Pfister R; Department of Internal Medicine III, Heart Center University of Cologne, Cologne, Germany., Cuneo A; Krankenhaus 'Maria Hilf' Medizinische Klinik, Stadtlohn, Germany., Jacobshagen C; Clinic for Cardiology and Pneumology, Georg August University Goettingen, Goettingen, Germany.; Vincentius-Diakonissen Hospital, Karlsruhe, Germany., Karakas M; Department of Intensive Care Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.; DZHK (German Centre for Cardiovascular Research), Partner Site Hamburg/Kiel/Luebeck, Hamburg, Germany., Koenig W; Deutsches Herzzentrum München, Technische Universität München, Munich, Germany.; DZHK (German Centre for Cardiovascular Research), Partner Site Munich Heart Alliance, Munich, Germany., Pott A; Department of Internal Medicine II-Cardiology, Medical Center, University of Ulm, Ulm, Germany., Meyer P; Service de Cardiologie, Hôpitaux Universitaires de Genève, Geneva, Switzerland., Roffi M; Service de Cardiologie, Hôpitaux Universitaires de Genève, Geneva, Switzerland., Banning A; Department of Cardiology, John Radcliffe Hospital, Oxford University Hospitals, Oxford, UK., Wolfrum M; Department of Cardiology, Kantonsspital Lucerne, Lucerne, Switzerland., Cuculi F; Department of Cardiology, Kantonsspital Lucerne, Lucerne, Switzerland., Kobza R; Department of Cardiology, Kantonsspital Lucerne, Lucerne, Switzerland., Fischer TA; Department of Cardiology, Kantonsspital Winterthur, Winterthur, Switzerland., Vasankari T; Heart Center, Turku University Hospital, University of Turku, Turku, Finland., Airaksinen KEJ; Heart Center, Turku University Hospital, University of Turku, Turku, Finland., Napp LC; Department of Cardiology and Angiology, Hannover Medical School, Hannover, Germany., Dworakowski R; Department of Cardiology, King's College Hospital, London, UK., MacCarthy P; Department of Cardiology, King's College Hospital, London, UK., Kaiser C; Department of Cardiology, University Hospital Basel, Basel, Switzerland., Osswald S; Department of Cardiology, University Hospital Basel, Basel, Switzerland., Galiuto L; Fondazione Policlinico Universitario A. Gemelli IRCCS, Catholic University of the Sacred Heart, Rome, Italy., Chan C; Department of Cardiology, Christchurch Hospital, Christchurch, New Zealand., Bridgman P; Department of Cardiology, Christchurch Hospital, Christchurch, New Zealand., Beug D; Department of Cardiology and Internal Medicine B, University Medicine Greifswald, Greifswald, Germany.; DZHK (German Centre for Cardiovascular Research), Partner Site Greifswald, Greifswald, Germany., Delmas C; Department of Cardiology and Cardiac Imaging Center, University Hospital of Rangueil, Toulouse, France., Lairez O; Department of Cardiology and Cardiac Imaging Center, University Hospital of Rangueil, Toulouse, France., Gilyarova E; Intensive Coronary Care Unit, Moscow City Hospital No 1 named after N. Pirogov, Moscow, Russia., Shilova A; Intensive Coronary Care Unit, Moscow City Hospital No 1 named after N. Pirogov, Moscow, Russia., Gilyarov M; Intensive Coronary Care Unit, Moscow City Hospital No 1 named after N. Pirogov, Moscow, Russia., El-Battrawy I; First Department of Medicine, Faculty of Medicine, University Medical Centre Mannheim (UMM), University of Heidelberg, Mannheim, Germany.; DZHK (German Center for Cardiovascular Research), Partner Site, Heidelberg-Mannheim, Mannheim, Germany., Akin I; First Department of Medicine, Faculty of Medicine, University Medical Centre Mannheim (UMM), University of Heidelberg, Mannheim, Germany.; DZHK (German Center for Cardiovascular Research), Partner Site, Heidelberg-Mannheim, Mannheim, Germany., Poledniková K; Cardiocenter, Third Faculty of Medicine, Charles University in Prague and University Hospital Královské Vinohrady, Prague, Czech Republic., Toušek P; Cardiocenter, Third Faculty of Medicine, Charles University in Prague and University Hospital Královské Vinohrady, Prague, Czech Republic., Winchester DE; Division of Cardiovascular Medicine, Department of Medicine, College of Medicine, University of Florida, Gainesville, FL, USA., Massoomi M; Division of Cardiovascular Medicine, Department of Medicine, College of Medicine, University of Florida, Gainesville, FL, USA., Galuszka J; Department of Internal Medicine I-Cardiology, University Hospital Olomouc, Olomouc, Czech Republic., Ukena C; Klinik für Innere Medizin III, Universitätsklinikum des Saarlandes, Homburg/Saar, Germany., Poglajen G; Advanced Heart Failure and Transplantation Center, University Medical Center Ljubljana, Ljubljana, Slovenia., Carrilho-Ferreira P; CHULN, Center of Cardiology of the University of Lisbon, Lisbon School of Medicine, Lisbon Academic Medical Center, Santa Maria University Hospital, Lisbon, Portugal., Hauck C; Klinik und Poliklinik für Innere Medizin II, Universitätsklinikum Regensburg, Regensburg, Germany., Paolini C; Local Health Unit n. 8, Cardiology Unit, Vicenza, Italy., Bilato C; Local Health Unit n. 8, Cardiology Unit, Vicenza, Italy., Kobayashi Y; Department of Cardiovascular Medicine, Chiba University Graduate School of Medicine, Chiba, Japan., Kato K; Department of Cardiovascular Medicine, Chiba University Graduate School of Medicine, Chiba, Japan., Ishibashi I; Department of Cardiology, Chiba Emergency Medical Center, Chiba, Japan., Himi T; Division of Cardiology, Kimitsu Central Hospital, Kisarazu, Japan., Din J; Dorset Heart Centre, Royal Bournemouth Hospital, Bournemouth, UK., Al-Shammari A; Dorset Heart Centre, Royal Bournemouth Hospital, Bournemouth, UK., Prasad A; Department of Cardiovascular Diseases, Mayo Clinic, Rochester, MN, USA., Rihal CS; Department of Cardiovascular Diseases, Mayo Clinic, Rochester, MN, USA., Liu K; Division of Cardiology, Heart and Vascular Center, University of Iowa, Iowa City, IA, USA., Schulze PC; Department of Internal Medicine I, University Hospital Jena, Friedrich-Schiller-University Jena, Jena, Germany., Bianco M; Division of Cardiology, A.O.U. San Luigi Gonzaga, Turin, Italy., Jörg L; Department of Cardiology, Kantonsspital St. Gallen, St. Gallen, Switzerland., Rickli H; Department of Cardiology, Kantonsspital St. Gallen, St. Gallen, Switzerland., Pestana G; Department of Cardiology, Centro Hospitalar Universitário de São João, Porto, Portugal., Nguyen TH; Department of Cardiology, Basil Hetzel Institute, Queen Elizabeth Hospital, University of Adelaide, Adelaide, SA, Australia., Böhm M; Klinik für Innere Medizin III, Universitätsklinikum des Saarlandes, Homburg/Saar, Germany., Maier LS; Klinik und Poliklinik für Innere Medizin II, Universitätsklinikum Regensburg, Regensburg, Germany., Pinto FJ; CHULN, Center of Cardiology of the University of Lisbon, Lisbon School of Medicine, Lisbon Academic Medical Center, Santa Maria University Hospital, Lisbon, Portugal., Widimský P; Cardiocenter, Third Faculty of Medicine, Charles University in Prague and University Hospital Královské Vinohrady, Prague, Czech Republic., Felix SB; Department of Cardiology and Internal Medicine B, University Medicine Greifswald, Greifswald, Germany.; DZHK (German Centre for Cardiovascular Research), Partner Site Greifswald, Greifswald, Germany., Braun-Dullaeus RC; Department of Internal Medicine, Cardiology and Angiology, Magdeburg University, Magdeburg, Germany., Rottbauer W; Department of Internal Medicine II-Cardiology, Medical Center, University of Ulm, Ulm, Germany., Hasenfuß G; Clinic for Cardiology and Pneumology, Georg August University Goettingen, Goettingen, Germany., Pieske BM; Department of Cardiology, Charité, Campus Rudolf Virchow, Berlin, Germany.; Berlin Institute of Health (BIH), Berlin, Germany., Schunkert H; Deutsches Herzzentrum München, Technische Universität München, Munich, Germany.; DZHK (German Centre for Cardiovascular Research), Partner Site Munich Heart Alliance, Munich, Germany., Budnik M; Department of Cardiology, Medical University of Warsaw, Warsaw, Poland., Opolski G; Department of Cardiology, Medical University of Warsaw, Warsaw, Poland., Thiele H; Department of Internal Medicine/Cardiology, Heart Center Leipzig, University Hospital, Leipzig, Germany., Bauersachs J; Department of Cardiology and Angiology, Hannover Medical School, Hannover, Germany., Horowitz JD; Department of Cardiology, Basil Hetzel Institute, Queen Elizabeth Hospital, University of Adelaide, Adelaide, SA, Australia., Di Mario C; Structural Interventional Cardiology, Careggi University Hospital, Florence, Italy., Bruno F; Division of Cardiology, Department of Medical Sciences, AOU Città della Salute e della Scienza, University of Turin, Turin, Italy., Kong W; Department of Cardiology, National University Heart Centre, Singapore, Singapore., Dalakoti M; Department of Cardiology, National University Heart Centre, Singapore, Singapore., Imori Y; Department of Cardiovascular Medicine, Nippon Medical School, Tokyo, Japan., Münzel T; Center for Cardiology, Cardiology 1, University Medical Center Mainz, Mainz, Germany., Crea F; Fondazione Policlinico Universitario A. Gemelli IRCCS, Catholic University of the Sacred Heart, Rome, Italy., Lüscher TF; Center for Molecular Cardiology, Schlieren Campus, University of Zurich, Zurich, Switzerland.; Royal Brompton and Harefield Hospitals Trust and Imperial College and Kings College, London, UK., Bax JJ; Department of Cardiology, Leiden University Medical Centre, Leiden, The Netherlands., Ruschitzka F; Department of Cardiology, University Heart Center, University Hospital Zurich, and University of Zurich, Zurich, Switzerland., De Ferrari GM; Division of Cardiology, Department of Medical Sciences, AOU Città della Salute e della Scienza, University of Turin, Turin, Italy., Fariselli P; Department of Medical Sciences, University of Turin, Turin, Italy., Ghadri JR; Department of Cardiology, University Heart Center, University Hospital Zurich, and University of Zurich, Zurich, Switzerland., Citro R; Department of Vascular Physiopathology, IRCCS Neuromed, Pozzilli, Italy.; Department of Cardio-Thoracic-Vascular, University Hospital San Giovanni di Dio e Ruggi d'Aragona, Salerno, Italy., D'Ascenzo F; Division of Cardiology, Department of Medical Sciences, AOU Città della Salute e della Scienza, University of Turin, Turin, Italy., Templin C; Department of Cardiology, University Heart Center, University Hospital Zurich, and University of Zurich, Zurich, Switzerland.
Jazyk:	angličtina
Zdroj:	European journal of heart failure [Eur J Heart Fail] 2023 Dec; Vol. 25 (12), pp. 2299-2311. Date of Electronic Publication: 2023 Sep 18.
DOI:	10.1002/ejhf.2983
Abstrakt:	Aims: Takotsubo syndrome (TTS) is associated with a substantial rate of adverse events. We sought to design a machine learning (ML)-based model to predict the risk of in-hospital death and to perform a clustering of TTS patients to identify different risk profiles. Methods and Results: A ridge logistic regression-based ML model for predicting in-hospital death was developed on 3482 TTS patients from the International Takotsubo (InterTAK) Registry, randomly split in a train and an internal validation cohort (75% and 25% of the sample size, respectively) and evaluated in an external validation cohort (1037 patients). Thirty-one clinically relevant variables were included in the prediction model. Model performance represented the primary endpoint and was assessed according to area under the curve (AUC), sensitivity and specificity. As secondary endpoint, a K-medoids clustering algorithm was designed to stratify patients into phenotypic groups based on the 10 most relevant features emerging from the main model. The overall incidence of in-hospital death was 5.2%. The InterTAK-ML model showed an AUC of 0.89 (0.85-0.92), a sensitivity of 0.85 (0.78-0.95) and a specificity of 0.76 (0.74-0.79) in the internal validation cohort and an AUC of 0.82 (0.73-0.91), a sensitivity of 0.74 (0.61-0.87) and a specificity of 0.79 (0.77-0.81) in the external cohort for in-hospital death prediction. By exploiting the 10 variables showing the highest feature importance, TTS patients were clustered into six groups associated with different risks of in-hospital death (28.8% vs. 15.5% vs. 5.4% vs. 1.0.8% vs. 0.5%) which were consistent also in the external cohort. Conclusion: A ML-based approach for the identification of TTS patients at risk of adverse short-term prognosis is feasible and effective. The InterTAK-ML model showed unprecedented discriminative capability for the prediction of in-hospital death. (© 2023 The Authors. European Journal of Heart Failure published by John Wiley & Sons Ltd on behalf of European Society of Cardiology.)
Databáze:	MEDLINE
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