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Submitted: 24 Aug 2024
Revision: 27 Jun 2025
Accepted: 13 Jul 2025
ePublished: 28 Sep 2025
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J Cardiovasc Thorac Res. 2025;17(3): 181-187.
doi: 10.34172/jcvtr.025.33340
PMID: 41255487
PMCID: PMC12620144
  Abstract View: 537
  PDF Download: 380

Original Article

Predictive model of neurocognitive functioning after acute coronary syndrome. A machine learning approach

Inês Moreira 1, Miguel Peixoto 2, Dulce Sousa 3, Afonso Rocha 4,5, Bruno Peixoto 1,6,7* ORCID logo

1 Department of Social and Behavioral Sciences of University Institute of Health Sciences, Gandra, Portugal
2 Psychosocial Rehabilitation Laboratory, Rehabilitation Investigation Center, School of Health, Polytechnic University of Porto, Gandra, Portugal
3 Department of Psychology, Unidade Local de Saúde de São João, Gandra, Portugal
4 Cardiocare Research Group, Faculty of Medicine, University of Porto, Gandra, Portugal
5 Department of Physical and Rehabilitation Medicine, Unidade Local de Saúde de São João, Gandra, Portugal
6 Associate Laboratory i4HB - Institute for Health and Bioeconomy, University Institute of Health Sciences – CESPU, Gandra, Portugal
7 UCIBIO - Applied Molecular Biosciences Unit, Translational Toxicology Research Laboratory, University Institute of Health Sciences , Gandra, Portugal
*Corresponding Author: Bruno Peixoto, Email: nesnunesmoreira@gmail.com

Abstract

Introduction: The interplay between coronary disease and neurocognitive dysfunction remains unclear with several underlying factors likely contributing to this complex relationship. This study develops a predictive model using a machine learning approach to determine a predictive model of neurocognitive functioning in patients with acute coronary syndrome (ACS).

Methods: Sixty-three patients, enrolled in the phase III cardiac rehabilitation program, underwent a neurocognitive assessment. To predict neurocognitive functioning a cross validated random forest model was used (RF_cv) due to its robustness to non-linear relationships and overfitting, and its successful application in prior disease prediction studies.

Results: The RF_cv model showed an r-squared of 0.978, an RMSE of 0.6309 and a MAE value of 0.479. The top-ten predictors in the model were: HDL, Depression, Glucose, Glycated Hemoglobin, B-Type Natriuretic Peptide, BMI (Kg/m2), Waist-to-Hip Ratio, Cholesterol, Anxiety and Age.

Conclusion: The variance in neurocognitive functioning is explained by a combination of biochemical indicators and body composition, reflecting classical cardiovascular risk factors and depression. The obtained RF-cv predictive model supports early identification of patients for tailored interventions.


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