Designing a machine learning model for predicting cardiovascular events using the triglyceride-glucose index: a cohort study

INTRODUCTION: Cardiovascular diseases (CVD) are the leading cause of death in developing countries, imposing a significant burden on society. Early detection of patients at higher risk of CVD events could reduce mortality. None of the models currently used for this purpose incorporates insulin resistance (IR), which can be measured using triglyceride and glucose levels. This study aims to explore the effectiveness of the triglyceride-glucose (TyG) index in predicting CVD events using machine learning models. METHODS AND MATERIALS: This study utilized data from the Mashhad Stroke and Heart Atherosclerotic Disorder (MASHAD) cohort. Patients were evaluated at baseline and monitored for over ten years for CVD events. Eleven machine learning models, including a multilayer perceptron (MLP) and a decision tree, were used to evaluate the predictive value of the TyG index in conjunction with traditional risk factors. RESULTS: The study population had a CVD event prevalence rate of 10.9%. The average age was 48.08 ± 8.26 years, with 60.0% of participants being female. The mean TyG index was 8.59 ± 0.66. The MLP and AdaBoost classifier models demonstrated the highest predictive accuracy with ROC-AUC scores of 0.77 and 0.766, respectively. The TyG index was identified as the fourth most significant predictor in the AdaBoost Classifier and MLP models, although it ranked lower in other models. CONCLUSION: This study highlights the potential benefits of incorporating the TyG index into traditional CVD risk prediction models to enhance accuracy and applicability, especially in developing countries.