AUTHOR=He Yu-Chan , Li Ye , Qin Xiu-Jin , Bi Zhong-Hai , Li Si-Yao , Liu Yan-Li , Miao Liu 

TITLE=Construction of diagnostic and prognostic models for premature coronary artery disease based on multiple machine algorithms

JOURNAL=Frontiers in Cardiovascular Medicine

VOLUME=Volume 12 - 2025

YEAR=2025

URL=https://www.frontiersin.org/journals/cardiovascular-medicine/articles/10.3389/fcvm.2025.1611709

DOI=10.3389/fcvm.2025.1611709

ISSN=2297-055X

ABSTRACT=ObjectiveTo evaluate the diagnostic and prognostic predictive value of the pan-immune-inflammation value (PIV) and triglyceride-glucose (TyG) index in premature coronary artery disease (PCAD).MethodsThis study analyzed data from 26,883 patients admitted with chest pain at Liuzhou People's Hospital (January 2014 to December 2020), with 5,653 patients included after screening. Multiple machine learning algorithms, including Gradient Boosting Machine (GBM), Extreme Gradient Boosting (XGBoost), Support Vector Machine (SVM), Lasso regression, Random Forest (RF), and logistic regression, were applied to identify PCAD-related variables, which were integrated into a decision tree model. Propensity score matching (PSM) ensured cohort comparability. The Mime1 package facilitated ensemble feature selection and visualization, while optimal PIV and TyG cutoff values were determined via Receiver Operating Characteristic (ROC) analysis for 36-month survival subgroup analysis.ResultsLogistic regression identified PIV [odds ratio [OR] 2.651, 95% CI [to be specified], P < 0.001] and TyG [OR 1.003, 95% CI (to be specified), P < 0.001] as PCAD risk factors. The decision tree model, incorporating PIV, TyG, and white blood cell count (WBC), achieved an accuracy of 0.88 and an area under the ROC curve (AUC) of 0.86 for PCAD diagnosis. Survival analysis over 36 months revealed that low PIV and TyG levels were associated with reduced all-cause mortality, whereas elevated levels correlated with poorer prognosis (P < 0.001), with TyG showing a pronounced effect.ConclusionThe combined evaluation of PIV, TyG, and WBC offers robust diagnostic and prognostic value for PCAD, with elevated PIV and TyG levels indicating a poor prognosis, underscoring their potential as clinical biomarkers.