Machine Learning-Based Risk Assessment for Cancer Therapy-Related Cardiac Dysfunction in 4300 Longitudinal Oncology Patients.

Aged Algorithms Antineoplastic Agents / adverse effects Cardiotoxicity / diagnosis Female Humans Machine Learning Male Middle Aged Neoplasms / complications Predictive Value of Tests ROC Curve Retrospective Studies Risk Assessment
anthracycline therapy cancer therapy–related cardiac dysfunction cardiotoxicity cardio‐oncology echocardiography machine learning

Journal

Journal of the American Heart Association
ISSN: 2047-9980
Titre abrégé: J Am Heart Assoc
Pays: England
ID NLM: 101580524

Informations de publication

Date de publication:
12 2020
Historique:
pubmed: 27 11 2020
medline: 27 3 2021
entrez: 26 11 2020
Statut: ppublish

Résumé

Background The growing awareness of cardiovascular toxicity from cancer therapies has led to the emerging field of cardio-oncology, which centers on preventing, detecting, and treating patients with cardiac dysfunction before, during, or after cancer treatment. Early detection and prevention of cancer therapy-related cardiac dysfunction (CTRCD) play important roles in precision cardio-oncology. Methods and Results This retrospective study included 4309 cancer patients between 1997 and 2018 whose laboratory tests and cardiovascular echocardiographic variables were collected from the Cleveland Clinic institutional electronic medical record database (Epic Systems). Among these patients, 1560 (36%) were diagnosed with at least 1 type of CTRCD, and 838 (19%) developed CTRCD after cancer therapy (de novo). We posited that machine learning algorithms can be implemented to predict CTRCDs in cancer patients according to clinically relevant variables. Classification models were trained and evaluated for 6 types of cardiovascular outcomes, including coronary artery disease (area under the receiver operating characteristic curve [AUROC], 0.821; 95% CI, 0.815-0.826), atrial fibrillation (AUROC, 0.787; 95% CI, 0.782-0.792), heart failure (AUROC, 0.882; 95% CI, 0.878-0.887), stroke (AUROC, 0.660; 95% CI, 0.650-0.670), myocardial infarction (AUROC, 0.807; 95% CI, 0.799-0.816), and de novo CTRCD (AUROC, 0.802; 95% CI, 0.797-0.807). Model generalizability was further confirmed using time-split data. Model inspection revealed several clinically relevant variables significantly associated with CTRCDs, including age, hypertension, glucose levels, left ventricular ejection fraction, creatinine, and aspartate aminotransferase levels. Conclusions This study suggests that machine learning approaches offer powerful tools for cardiac risk stratification in oncology patients by utilizing large-scale, longitudinal patient data from healthcare systems.

Identifiants

DOI: 10.1161/JAHA.120.019628 PMID: 33241727 PMC: PMC7763760
pubmed: 33241727
doi: 10.1161/JAHA.120.019628
pmc: PMC7763760
doi:

Substances chimiques

Antineoplastic Agents 0

Types de publication

Journal Article Research Support, N.I.H., Extramural

Langues

eng

Sous-ensembles de citation

IM

Pagination

e019628

Subventions

Organisme : NHLBI NIH HHS
ID : K99 HL138272
Pays : United States
Organisme : NHLBI NIH HHS
ID : R00 HL138272
Pays : United States

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Auteurs

Yadi Zhou (Y)

Genomic Medicine Institute Lerner Research InstituteCleveland Clinic Cleveland OH.

Yuan Hou (Y)

Genomic Medicine Institute Lerner Research InstituteCleveland Clinic Cleveland OH.

Muzna Hussain (M)

Robert and Suzanne Tomsich Department of Cardiovascular Medicine Sydell and Arnold Miller Family Heart and Vascular Institute Cleveland Clinic Cleveland OH.
School of Medicine Dentistry and Biomedical Sciences Wellcome-Wolfson Institute of Experimental MedicineQueen's University Belfast United Kingdom.

Sherry-Ann Brown (SA)

Cardio-Oncology Program Division of Cardiovascular Medicine Medical College of Wisconsin Milwaukee WI.

Thomas Budd (T)

Department of Hematology/Medical Oncology Taussig Cancer InstituteCleveland Clinic Cleveland OH.

W H Wilson Tang (WHW)

Robert and Suzanne Tomsich Department of Cardiovascular Medicine Sydell and Arnold Miller Family Heart and Vascular Institute Cleveland Clinic Cleveland OH.
Department of Molecular Medicine Cleveland Clinic Lerner College of MedicineCase Western Reserve University Cleveland OH.

Jame Abraham (J)

Department of Hematology/Medical Oncology Taussig Cancer InstituteCleveland Clinic Cleveland OH.

Bo Xu (B)

Robert and Suzanne Tomsich Department of Cardiovascular Medicine Sydell and Arnold Miller Family Heart and Vascular Institute Cleveland Clinic Cleveland OH.

Chirag Shah (C)

Department of Radiation Oncology Taussig Cancer InstituteCleveland Clinic Cleveland OH.

Rohit Moudgil (R)

Robert and Suzanne Tomsich Department of Cardiovascular Medicine Sydell and Arnold Miller Family Heart and Vascular Institute Cleveland Clinic Cleveland OH.

Zoran Popovic (Z)

Robert and Suzanne Tomsich Department of Cardiovascular Medicine Sydell and Arnold Miller Family Heart and Vascular Institute Cleveland Clinic Cleveland OH.

Leslie Cho (L)

Robert and Suzanne Tomsich Department of Cardiovascular Medicine Sydell and Arnold Miller Family Heart and Vascular Institute Cleveland Clinic Cleveland OH.

Mohamed Kanj (M)

Robert and Suzanne Tomsich Department of Cardiovascular Medicine Sydell and Arnold Miller Family Heart and Vascular Institute Cleveland Clinic Cleveland OH.

Chris Watson (C)

School of Medicine Dentistry and Biomedical Sciences Wellcome-Wolfson Institute of Experimental MedicineQueen's University Belfast United Kingdom.

Brian Griffin (B)

Robert and Suzanne Tomsich Department of Cardiovascular Medicine Sydell and Arnold Miller Family Heart and Vascular Institute Cleveland Clinic Cleveland OH.

Mina K Chung (MK)

Robert and Suzanne Tomsich Department of Cardiovascular Medicine Sydell and Arnold Miller Family Heart and Vascular Institute Cleveland Clinic Cleveland OH.
Department of Molecular Medicine Cleveland Clinic Lerner College of MedicineCase Western Reserve University Cleveland OH.

Samir Kapadia (S)

Robert and Suzanne Tomsich Department of Cardiovascular Medicine Sydell and Arnold Miller Family Heart and Vascular Institute Cleveland Clinic Cleveland OH.

Lars Svensson (L)

Department of Cardiovascular Surgery Cleveland Clinic Cleveland OH.

Patrick Collier (P)

Robert and Suzanne Tomsich Department of Cardiovascular Medicine Sydell and Arnold Miller Family Heart and Vascular Institute Cleveland Clinic Cleveland OH.
Department of Molecular Medicine Cleveland Clinic Lerner College of MedicineCase Western Reserve University Cleveland OH.

Feixiong Cheng (F)

Genomic Medicine Institute Lerner Research InstituteCleveland Clinic Cleveland OH.
Department of Hematology/Medical Oncology Taussig Cancer InstituteCleveland Clinic Cleveland OH.
Case Comprehensive Cancer Center Case Western Reserve University School of Medicine Cleveland OH.

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