Key result
Machine learning accurately predicts MACE, identifying METS-IR and waist circumference as top metabolic predictors.
Why the study?
Cardiovascular diseases are a leading cause of global morbidity and mortality, prompting an evaluation of novel metabolic indices to predict major adverse cardiovascular events and assess their relationships with diabetes and cardiovascular risks.
Do metabolic indices (TyG, HOMA-IR, TG/HDL-C, VAI, METS-IR) predict major adverse cardiovascular events in US adults?
Observational (n=16,324)
Do metabolic indices (TyG, HOMA-IR, TG/HDL-C, VAI, METS-IR) predict major adverse cardiovascular events in US adults?
Machine learning models demonstrate that metabolic indices, particularly METS-IR and waist circumference, are strong predictors of major adverse cardiovascular events, highlighting their potential for risk stratification.
Cardiovascular diseases such as coronary artery disease, myocardial infarction, and heart failure impact millions of people annually globally and are a major cause of disease and death. This study explores the predictive capabilities of novel metabolic indices (TyG, HOMA-IR, TG/HDL-C, and VAI) for major adverse cardiovascular events (MACE) and analyzes their relationships with diabetes and cardiovascular risks. Using data from the National Health and Nutrition Examination Survey (NHANES) spanning from 2003 to 2018, we applied multiple machine learning algorithms to evaluate nine metabolic indicators including cholesterol levels, triglycerides, insulin, and waist circumference. Through cross-validation to validate model performance, the XGBoost algorithm demonstrated the most accurate performance in predicting cardiovascular outcomes, particularly for diseases like angina and heart failure. Additionally, SHAP value analysis confirmed the critical roles of waist circumference and METS-IR in predicting adverse cardiovascular events. Furthermore, we employed 100 machine learning algorithms to calculate the AUC values of metabolic indicators in predicting AP, CHD, HF, and MI, showing that METS-IR had the greatest contribution in these aspects. This research highlights the significance of metabolic indices in stratifying cardiovascular risks and presents potential avenues for targeted preventive strategies.
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Li et al. (2025) conducted an observational in Major Adverse Cardiovascular Events (Angina, Coronary Disease, Myocardial Infarction, Heart Failure) (n=16,324). Metabolic indicators and scores (METS-IR, TyG, HOMA-IR, TG/HDL-C, VAI, waist circumference, BMI) vs. Lower metabolic risk scores was evaluated on Prediction of major adverse cardiovascular events (MACE) including angina, CHD, MI, and HF using machine learning algorithms. Machine learning algorithms accurately predicted cardiovascular events, with SHAP analysis confirming METS-IR and waist circumference as the most critical metabolic predictors for adverse outcomes.
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