{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T03:30:38Z","timestamp":1790134238076,"version":"4.0.1"},"reference-count":37,"publisher":"Oxford University Press (OUP)","issue":"12","license":[{"start":{"date-parts":[[2026,2,18]],"date-time":"2026-02-18T00:00:00Z","timestamp":1771372800000},"content-version":"vor","delay-in-days":435,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2024,12,10]],"date-time":"2024-12-10T00:00:00Z","timestamp":1733788800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100008530","name":"Fonds Europ\u00e9en de D\u00e9veloppement R\u00e9gional","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100008530","id-type":"DOI","asserted-by":"crossref"}]},{"name":"Contrat de Plan Etat R\u00e9gion Lorraine"},{"DOI":"10.13039\/501100008530","name":"European Regional Development Fund","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100008530","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2025,12,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>Patients experiencing ischaemic heart failure with reduced ejection fraction (HFrEF) represent a diverse group. We hypothesize that machine learning clustering can help separate distinctive patient phenotypes, paving the way for personalized management.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>A total of 8591 ischaemic HFrEF patients pooled from the EPHESUS and CAPRICORN trials (64\u2009\u00b1\u200912\u2009years; 28% women) were included in this analysis. Clusters were identified using both clinical and biological variables. Association between clusters and the composite of (i) heart failure hospitalization or all-cause death, (ii) cardiovascular (CV) hospitalization or all-cause death, and (iii) major adverse CV events was assessed. The derived algorithm was applied in the COMMANDER-HF trial (n\u2009=\u20095022) for external validation. Five clinical distinctive clusters were identified: Cluster 1 (n\u2009=\u20092161) with the older patients, higher prevalence of atrial fibrillation and previous CV events; Cluster 2 (n\u2009=\u20091376) with the higher prevalence of older hypertensive women and smoking habit; Cluster 3 (n\u2009=\u20091157) with the higher prevalence of diabetes and peripheral artery disease; Cluster 4 (n\u2009=\u20092073) with relatively younger patients, mostly men and with the higher left ventricular ejection fraction; Cluster 5 (n\u2009=\u20091824) with the younger patients and lower CV events burden. Cluster membership was efficiently predicted by a random forest algorithm. Clusters were significantly associated with outcomes in derivation and validation datasets, with Cluster 1 having the highest risk, and Cluster 4 the lowest. Mineralocorticoid receptor antagonist benefit on CV hospitalization or all-cause death was magnified in clusters with the lowest risk of events (Clusters 2 and 4).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Clustering reveals distinct risk subgroups in the heterogeneous array of ischaemic HFrEF patients. This classification, accessible online, could enhance future outcome predictions for ischaemic HFrEF cases.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ejhf.3547","type":"journal-article","created":{"date-parts":[[2024,12,10]],"date-time":"2024-12-10T03:10:21Z","timestamp":1733800221000},"page":"3378-3391","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["Machine Learning Approach to Identify Phenotypes in Patients with Ischaemic Heart Failure with Reduced Ejection Fraction"],"prefix":"10.1093","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2958-943X","authenticated-orcid":false,"given":"Luca","family":"Monzo","sequence":"first","affiliation":[{"name":"Universit\u00e9 de Lorraine, INSERM, Centre d'Investigations Cliniques Plurith\u00e9matique 1433, Inserm U1116, CHRU de Nancy and F-CRIN INI-CRCT , Nancy ,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emmanuel","family":"Bresso","sequence":"additional","affiliation":[{"name":"Universit\u00e9 de Lorraine, INSERM, Centre d'Investigations Cliniques Plurith\u00e9matique 1433, Inserm U1116, CHRU de Nancy and F-CRIN INI-CRCT , Nancy ,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kenneth","family":"Dickstein","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University of Bergan, Stavanger University Hospital , Stavanger ,","place":["Norway"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bertram","family":"Pitt","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine, University of Michigan , Ann Arbor, MI ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John G.F.","family":"Cleland","sequence":"additional","affiliation":[{"name":"Robertson Centre for Biostatistics and Clinical Trials, University of Glasgow , Glasgow ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefan D.","family":"Anker","sequence":"additional","affiliation":[{"name":"Berlin-Brandenburg Center for Regenerative Therapies , Berlin ,","place":["Germany"]},{"name":"Department of Cardiology, German Center for Cardiovascular Research, Partner Site Berlin, Charite Universitatsmedizin Berlin , Berlin ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carolyn S.P.","family":"Lam","sequence":"additional","affiliation":[{"name":"National Heart Centre Singapore, Duke-National University of Singapore , Singapore ,","place":["Singapore"]},{"name":"Department of Cardiology, University Medical Center Groningen, University of Groningen , Groningen ,","place":["The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mandeep 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