{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T06:02:34Z","timestamp":1790402554903,"version":"4.1.0"},"reference-count":56,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2024,12,11]],"date-time":"2024-12-11T00:00:00Z","timestamp":1733875200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Eur J Clin Investigation"],"published-print":{"date-parts":[[2025,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Although oral anticoagulation decreases the risk of thromboembolism in patients with atrial fibrillation (AF), a residual risk of thrombotic events still exists. This study aimed to construct machine learning (ML) models to predict the residual risk in these patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Patients with newly diagnosed non\u2010valvular AF were collected from the Global Registry on Long\u2010Term Oral Anti\u2010Thrombotic Treatment in Patients with Atrial Fibrillation (GLORIA\u2010AF) registry. To predict the residual risk of the composite outcome of thrombotic events (defined as ischemic stroke, systemic embolism, transient ischemic attack and myocardial infarction), we constructed four prediction models using the logistic regression (LR), random forest, light gradient boosting machine and extreme gradient boosting machine ML algorithms. Performance was mainly evaluated by area under the receiver\u2010operating characteristic curve (AUC), g\u2010means and F1 scores. Feature importance was evaluated by SHapley Additive exPlanations.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>15,829 AF patients (70.33\u2009\u00b1\u20099.94\u2009years old, 55% male) taking oral anticoagulation were included in our study, and 641 (4.0%) had residual risk, sustaining thrombotic events. In the test set, LR had the best performance with higher AUC trend of 0.712. RF has highest g\u2010means of 0.295 and F1 score of 0.249. This was superior when compared with the CHA<jats:sub>2<\/jats:sub>DS<jats:sub>2<\/jats:sub>\u2010VA score (AUC 0.698) and 2MACE score (AUC 0.696). Age, history of TE or MI, OAC discontinuation, eGFR and sex were identified as the top five factors associated with residual risk.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>ML algorithms can improve the prediction of residual risk of anticoagulated AF patients compared to clinical risk factor\u2010based scores.<\/jats:p><\/jats:sec>","DOI":"10.1111\/eci.14371","type":"journal-article","created":{"date-parts":[[2024,12,11]],"date-time":"2024-12-11T17:23:00Z","timestamp":1733937780000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":21,"title":["Residual risk prediction in anticoagulated patients with atrial fibrillation using machine learning: A report from the GLORIA\u2010AF registry phase II\/III"],"prefix":"10.1111","volume":"55","author":[{"given":"Yang","family":"Liu","sequence":"first","affiliation":[{"name":"Liverpool Centre for Cardiovascular Science at University of Liverpool, Liverpool John Moores University, and Liverpool Heart &amp; Chest Hospital  Liverpool UK"},{"name":"Department of Cardiovascular Medicine, the Second Affiliated Hospital, Jiangxi Medical College Nanchang University  Nanchang Jiangxi China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2808-6286","authenticated-orcid":false,"given":"Yang","family":"Chen","sequence":"additional","affiliation":[{"name":"Liverpool Centre for Cardiovascular Science at University of Liverpool, Liverpool John Moores University, and Liverpool Heart &amp; Chest Hospital  Liverpool UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5679-7501","authenticated-orcid":false,"given":"Ivan","family":"Olier","sequence":"additional","affiliation":[{"name":"Liverpool Centre for Cardiovascular Science at University of Liverpool, Liverpool John Moores University, and Liverpool Heart &amp; Chest Hospital  Liverpool UK"},{"name":"Data Science Research Centre Liverpool John Moores University  Liverpool UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9927-3209","authenticated-orcid":false,"given":"Sandra","family":"Ortega\u2010Martorell","sequence":"additional","affiliation":[{"name":"Liverpool Centre for Cardiovascular Science at University of Liverpool, Liverpool John Moores University, and Liverpool Heart &amp; Chest Hospital  Liverpool UK"},{"name":"Data Science Research Centre Liverpool John Moores University  Liverpool UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bi","family":"Huang","sequence":"additional","affiliation":[{"name":"Liverpool Centre for Cardiovascular Science at University of Liverpool, Liverpool John Moores University, and Liverpool Heart &amp; Chest Hospital  Liverpool UK"},{"name":"Department of Cardiology The First Affiliated Hospital of Chongqing Medical University  Chongqing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hironori","family":"Ishiguchi","sequence":"additional","affiliation":[{"name":"Liverpool Centre for Cardiovascular Science at University of Liverpool, Liverpool John Moores University, and Liverpool Heart &amp; Chest Hospital  Liverpool UK"},{"name":"Division of Cardiology, Department of Medicine and Clinical Science Yamaguchi University Graduate School of Medicine  Ube Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2147-0995","authenticated-orcid":false,"given":"Ho Man","family":"Lam","sequence":"additional","affiliation":[{"name":"Liverpool Centre for Cardiovascular Science at University of Liverpool, Liverpool John Moores University, and Liverpool Heart &amp; Chest Hospital  Liverpool UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kui","family":"Hong","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, the Second Affiliated Hospital, Jiangxi Medical College Nanchang University  Nanchang Jiangxi China"},{"name":"Department of Genetic Medicine the Second Affiliated Hospital of Nanchang University  Nanchang Jiangxi China"},{"name":"Jiangxi Key Laboratory of Molecular Medicine the Second Affiliated Hospital of Nanchang University  Nanchang China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Menno V.","family":"Huisman","sequence":"additional","affiliation":[{"name":"Department of Medicine \u2013 Thrombosis and Hemostasis Leiden University Medical Center  Leiden The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregory Y. 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