Machine Learning-Based Prediction of Coronary Artery Disease Using Clinical and Behavioral Data: A Comparative Study

<b>Background and Objectives:</b> Coronary artery disease (CAD) is a leading cause of morbidity and mortality worldwide. An early and accurate diagnosis is essential for effective clinical management and risk stratification. Recent advances in machine learning (ML) have provided opportunities to enhance the diagnostic performance by integrating multidimensional patient data. This study aimed to develop and compare several supervised ML algorithms for early CAD diagnosis using demographic, anthropometric, biochemical, and psychosocial parameters. <b>Materials and Methods:</b> A total of 300 adult patients (165 CAD-positive and 135 controls) were retrospectively analyzed using a dataset comprising 21 biochemical markers, body composition metrics, and self-reported eating behavior scores. Six ML algorithms, k-nearest neighbors (k-NNs), support vector machines (SVMs), artificial neural networks (ANNs), logistic regression (LR), naïve Bayes (NB), and decision trees (DTs), were trained and evaluated using 10-fold cross-validation. Model performance was assessed based on accuracy, sensitivity, false-negative rate, and area under the Receiver Operating Characteristic (ROC) curve (AUC). <b>Results:</b> The k-NN model achieved the highest performance, with 98.33% accuracy and an AUC of 0.99, followed by SVM (96.67%, AUC = 0.95) and ANN (95.33%, AUC = 0.98). Patients with CAD exhibited significantly higher levels of glucose, triglycerides (TGs), LDL cholesterol (LDL-C), and abdominal obesity, while vitamin B12 levels were lower (<i>p</i> < 0.001). Although emotional and mindful eating scores differed significantly between the groups, their contribution to model performance was limited. <b>Conclusions:</b> Machine learning models, particularly k-NN, SVM, and ANN, have demonstrated high accuracy in distinguishing CAD patients from healthy controls when applied to a diverse set of clinical and behavioral variables. This study highlights the potential of integrating psychosocial and clinical data to enhance CAD prediction models beyond traditional biomarkers.