Machine learning for predicting thrombotic recurrence in antiphospholipid syndrome

Ana Marco-Rico, Ihosvany Fernández-Bello, Jorge Mateo-Sotos, Pascual Marco-Vera,
Machine learning for predicting thrombotic recurrence in antiphospholipid syndrome,
Research and Practice in Thrombosis and Haemostasis,
Volume 9, Issue 7,
2025,
103198,
ISSN 2475-0379,
https://doi.org/10.1016/j.rpth.2025.103198.
(https://www.sciencedirect.com/science/article/pii/S2475037925005229)
Abstract: Background
Thrombotic antiphospholipid syndrome (TAPS) is an autoimmune disorder associated with a high risk of recurrent thromboembolic events. Despite advances in anticoagulation, predicting recurrence remains challenging, underscoring the need for more precise risk stratification to optimize personalized treatment. Traditional predictive models struggle to integrate the complexity of clinical and biochemical risk factors, creating an opportunity for machine learning to enhance prognostic accuracy.
Objective
In this study, we evaluated the performance of the extreme gradient boosting (XGB) model in predicting recurrent thrombotic events in TAPS, compared with other machine learning algorithms.
Methods
Demographic and clinical data were initially included, and model performance was assessed through multiple metrics, such as accuracy, specificity, precision, and the area under the receiver operating characteristic curve.
Results
XGB outperformed all other models, achieving the highest area under the receiver operating characteristic curve and accuracy, among other evaluated parameters, demonstrating robust predictive capabilities. Key predictors included renal impairment, age, and the presence of lupus anticoagulant, reinforcing the clinical relevance of these factors in risk assessment.
Conclusion
These findings highlight the potential of XGB to improve risk stratification and support clinical decision-making in TAPS. By identifying critical predictors, this approach may optimize anticoagulation strategies and enhance resource allocation. However, further validation in larger cohorts and prospective studies is necessary before clinical integration.
Keywords: antiphospholipid syndrome; machine learning; thrombosis; recurrence; risk assessment