A machine learning risk-stratification model successfully predicted 5-year clinical remission in patients with recurrent pericarditis, achieving a C-index of 0.800 (P<0.0001 for stratification).
Cohort (n=365)
A novel machine learning risk-stratification model can accurately predict clinical remission in patients with recurrent pericarditis, aiding in individualized treatment decisions.
Effect estimate: C-index 0.800
p-value: p=<0.0001
BACKGROUND Recurrent pericarditis (RP) is a complex condition associated with significant morbidity. Prior studies have evaluated which variables are associated with clinical remission. However, there is currently no established risk-stratification model for predicting outcomes in these patients. OBJECTIVES We developed a risk stratification model that can predict long-term outcomes in patients with RP and enable identification of patients with characteristics that portend poor outcomes. METHODS We retrospectively studied a total of 365 consecutive patients with RP from 2012 to 2019. The primary outcome was clinical remission (CR), defined as cessation of all anti-inflammatory therapy with complete resolution of symptoms. Five machine learning survival models were used to calculate the likelihood of CR within 5 years and stratify patients into high-risk, intermediate-risk, and low-risk groups. RESULTS Among the cohort, the mean age was 46 ± 15 years, and 205 (56%) were women. CR was achieved in 118 (32%) patients. The final model included steroid dependency, total number of recurrences, pericardial late gadolinium enhancement, age, etiology, sex, ejection fraction, and heart rate as the most important parameters. The model predicted the outcome with a C-index of 0.800 on the test set and exhibited a significant ability in stratification of patients into low-risk, intermediate-risk, and high-risk groups (log-rank test; P < 0.0001). CONCLUSIONS We developed a novel risk-stratification model for predicting CR in RP. Our model can also aid in stratifying patients, with high discriminative ability. The use of an explainable machine learning model can aid physicians in making individualized treatment decision in RP patients.
Yesilyaprak et al. (Sat,) conducted a cohort in Recurrent Pericarditis (n=365). Machine learning risk-stratification model was evaluated on Clinical remission (CR), defined as cessation of all anti-inflammatory therapy with complete resolution of symptoms (C-index 0.800, p=<0.0001). A machine learning risk-stratification model successfully predicted 5-year clinical remission in patients with recurrent pericarditis, achieving a C-index of 0.800 (P<0.0001 for stratification).