An Innovative Scoring System for Predicting Major Adverse Cardiac Events in Patients with Chest Pain Based on Machine Learning

Chieh Chen Wu, Wen Ding Hsu, Yao Chin Wang, Woon Man Kung, I. Shiang Tzeng, Chih Wei Huang, Chu Ya Huang, Yu Chuan Li

Research output: Contribution to journalArticlepeer-review

5 Citations (Scopus)


Chest pain is a common complaint in the emergency department, but this may prevent a diagnosis of major adverse cardiac events, a composite of all-cause mortality associated with cardiovascular-related illnesses. To determine potential predictors of major adverse cardiac events in Taiwan, a pilot study was performed, involving the data from 268 patients with major adverse cardiac events, which was by an artificial neural network method. Nine biomarkers were selected for identifying non-ST-elevation myocardial infarction from common chest pain patients. By using a machine learning-based feature selection technique, five biomarkers were chosen from a set of 37 candidate variables. A full and a reduced risk stratification model were built. The full model was based on the characteristics of both invasive (i.e., creatinine and troponin I) and non-invasive (i.e., age, coronary artery disease risk factors, and corrected QT interval) variables, and the reduced model was based only on non-invasive variable characteristics. The full model showed a sensitivity of 0.948 and a specificity of 0.546 when the cutoff was set at 2 points, with a missed major adverse cardiac events rate of 1.32%, a positive predictive value of 0.228, and a negative predictive value of 0.987. High performance was also obtained with the five major biomarkers in the predictor built by the machine learning algorithm. The full model had the highest performance, but the reduced model can be applied as a quick and reasonably performing diagnostic tool.

Original languageEnglish
Article number9123343
Pages (from-to)124076-124083
Number of pages8
JournalIEEE Access
Publication statusPublished - 2020


  • Chest pain
  • emergency department
  • machine learning
  • major adverse cardiac events
  • non-ST-elevation myocardial infarction
  • risk stratification
  • scoring system
  • ST-elevation myocardial infarction

ASJC Scopus subject areas

  • General Computer Science
  • General Materials Science
  • General Engineering


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