Evidence map›Paper›PMID 41593634›Full record

ArticleCardiovascular diabetology2026

Development and validation of a neural network survival prediction model for ischemic heart disease.

Peter C Holm, Amalie D Haue, David Westergaard, Timo Röder, Karina Banasik, Vinicius Tragante, Christian H Johansen, Alex H Christensen, Laurent Thomas, Therese H Nøst and 18 more

Abstract readValidation Study
In one paragraph

Article in Cardiovascular diabetology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

28 authors.

Peter C HolmNovo Nordisk Foundation Center for Protein Research, University of Copenhagen, Blegdamsvej 3B, 2200, Copenhagen, Denmark.ORCID http://orcid.org/0000-0003-3363-5611
Amalie D HaueNovo Nordisk Foundation Center for Protein Research, University of Copenhagen, Blegdamsvej 3B, 2200, Copenhagen, Denmark.ORCID http://orcid.org/0000-0001-7656-7976
David WestergaardNovo Nordisk Foundation Center for Protein Research, University of Copenhagen, Blegdamsvej 3B, 2200, Copenhagen, Denmark.ORCID http://orcid.org/0000-0003-0128-8432
Timo RöderNovo Nordisk Foundation Center for Protein Research, University of Copenhagen, Blegdamsvej 3B, 2200, Copenhagen, Denmark.ORCID http://orcid.org/0000-0001-6841-4056
Karina BanasikNovo Nordisk Foundation Center for Protein Research, University of Copenhagen, Blegdamsvej 3B, 2200, Copenhagen, Denmark.ORCID http://orcid.org/0000-0003-2489-2499
Vinicius TragantedeCODE Genetics, Sturlugata 8, 102, Reykjavik, Iceland.
Christian H JohansenNovo Nordisk Foundation Center for Protein Research, University of Copenhagen, Blegdamsvej 3B, 2200, Copenhagen, Denmark.ORCID http://orcid.org/0000-0001-8665-2111
Alex H ChristensenDepartment of Cardiology, The Heart Center, Copenhagen University Hospital, Rigshospitalet, Blegdamsvej 9, 2100, Copenhagen, Denmark.
Laurent ThomasDepartment of Clinical and Molecular Medicine, Norwegian University of Science and Technology, 7491, Trondheim, Norway.
Therese H NøstK.G. Jebsen Center for Genetic Epidemiology, Department of Public Health, Norwegian University of Science and Technology, 7491, Trondheim, Norway.
Anne-Heidi SkogholtK.G. Jebsen Center for Genetic Epidemiology, Department of Public Health, Norwegian University of Science and Technology, 7491, Trondheim, Norway.ORCID http://orcid.org/0000-0001-7466-0405
Kasper K IversenDepartment of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3B, 2200, Copenhagen, Denmark.ORCID http://orcid.org/0000-0003-0504-8487
Frants PedersenDepartment of Cardiology, The Heart Center, Copenhagen University Hospital, Rigshospitalet, Blegdamsvej 9, 2100, Copenhagen, Denmark.ORCID http://orcid.org/0000-0002-0071-3209
Dan E HøfstenDepartment of Cardiology, The Heart Center, Copenhagen University Hospital, Rigshospitalet, Blegdamsvej 9, 2100, Copenhagen, Denmark.ORCID http://orcid.org/0000-0002-7609-4141
Ole B PedersenDepartment of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3B, 2200, Copenhagen, Denmark.ORCID http://orcid.org/0000-0003-2312-5976
Sisse Rye OstrowskiDepartment of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3B, 2200, Copenhagen, Denmark.ORCID http://orcid.org/0000-0001-5288-3851
Henrik UllumDepartment of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3B, 2200, Copenhagen, Denmark.ORCID http://orcid.org/0000-0001-7306-9058
Mette N SvendsenDepartment of Public Health, University of Copenhagen, Øster Farimagsgade 5, 1353, Copenhagen, Denmark.ORCID http://orcid.org/0000-0002-4777-4973
Iben M GjødsbølDepartment of Public Health, University of Copenhagen, Øster Farimagsgade 5, 1353, Copenhagen, Denmark.ORCID http://orcid.org/0000-0003-3938-5211
Thorarinn GudnasonLaeknasetrid Cardiology Clinic, Thonglabakka 1, 109, Reykjavík, Iceland.ORCID http://orcid.org/0000-0001-6440-3712
Daníel F GuðbjartssondeCODE Genetics, Sturlugata 8, 102, Reykjavik, Iceland.ORCID http://orcid.org/0000-0002-5222-9857
Anna HelgadottirdeCODE Genetics, Sturlugata 8, 102, Reykjavik, Iceland.ORCID http://orcid.org/0000-0002-1806-2467
Kristian HveemK.G. Jebsen Center for Genetic Epidemiology, Department of Public Health, Norwegian University of Science and Technology, 7491, Trondheim, Norway.ORCID http://orcid.org/0000-0001-8157-9744
Lars V KøberDepartment of Cardiology, The Heart Center, Copenhagen University Hospital, Rigshospitalet, Blegdamsvej 9, 2100, Copenhagen, Denmark.ORCID http://orcid.org/0000-0002-6635-1466
Hilma HolmdeCODE Genetics, Sturlugata 8, 102, Reykjavik, Iceland.ORCID http://orcid.org/0000-0002-9517-6636
Kari StefanssondeCODE Genetics, Sturlugata 8, 102, Reykjavik, Iceland.ORCID http://orcid.org/0000-0003-1676-864X
Søren Brunak *Novo Nordisk Foundation Center for Protein Research, University of Copenhagen, Blegdamsvej 3B, 2200, Copenhagen, Denmark. soren.brunak@cpr.ku.dk.ORCID http://orcid.org/0000-0003-0316-5866
Henning Bundgaard *Department of Cardiology, The Heart Center, Copenhagen University Hospital, Rigshospitalet, Blegdamsvej 9, 2100, Copenhagen, Denmark.ORCID http://orcid.org/0000-0002-0563-7049

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundCurrent risk prediction models for ischemic heart disease in clinical use are relatively simple and use a limited collection of well-known risk factors. Using machine learning to integrate a broader panel of features from electronic health records (EHRs) may improve post-angiography prognostication.

methodsThis retrospective model development and validation study was based on Danish EHR data. Icelandic EHR data were used for external test. Patients with a coronary angiography-confirmed diagnosis of coronary atherosclerosis between 2006 and 2016 were included for model development (n = 39,746). Time to all-cause mortality, the prediction target, was tracked until 2019, or up to 5 years, whichever came first. To model time-to-event data and deal with censoring, neural network-based discrete-time survival models were used. The model, PMHnet, uses 584 different features including clinical characteristics, laboratory tests, and diagnosis and procedure codes. Model performance was evaluated using time-dependent AUC (tdAUC) and the Brier score. PMHnet was benchmarked against the updated GRACE2.0 risk score and less feature-rich neural network models. Models were evaluated using hold-out data (n = 5000) and external validation data from Iceland. Feature importance and model explainability were assessed using SHAP analysis.

resultsOn the test set (n = 5000), the tdAUC of PMHnet was 0.88 [ 0.86-0.90] (case count = 196) at six months, 0.88 [0.86-0.90] (cc = 261) at one year, 0.84 [0.82-0.86] (cc = 395) at three years, and 0.82 [0.80-0.84] (cc = 763) at five years. PMHnet showed similar performance in the Icelandic data. Compared to the GRACE2.0 score and intermediate models limited to GRACE2.0 features or single data modalities, PMHnet had significantly better model discrimination across all evaluated prediction timepoints.

conclusionsMore complex and feature-rich machine learning models can better predict all-cause mortality in ischemic heart disease and may be used by clinicians and patients to inform and guide treatment and management.

Indexed as

Coronary Artery DiseaseDecision Support TechniquesMyocardial IschemiaNeural Networks, ComputerPredictive Learning ModelsCoronary AngiographyDenmarkElectronic Health RecordsFemaleHeart Disease Risk FactorsHumansIcelandMalePrediction AlgorithmsPredictive Value of TestsPrognosisartificial intelligenceAtherosclerosiselectronic health recordsprognosticationrisk scoretime-to-event

Identifiers

PMID41593634
PMCPMC12918636

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