A survey on Cardiac Disease Prediction Using

Machine Learning Algorithms – A Review

Mukesh Raj1, Manan Agarwal2, Om Katiyar3, Manvendra Pathya4
Department of Computer Science and Engineering
JSS Academy of Technical Education, Noida-201301, India
E-mails: 1mukeshraj.2021t@gmail.com , 2mananagarwal1103@gmail.com ,
3omkatiyar604@gmail.com , 4manvendrapathya01@gmail.com

Abstract—As the vital organ regulating the rhythms of I. INTRODUCTION

the human body, the heart demands precise diagnosis.
Even minor diagnostic lapses can culminate in
debilitating fatigue or tragic outcomes, with the number
of cardiovascular mortality events increasing daily.
Considering escalating global concern regarding heart
disease, researchers have sought innovative solutions.
Machine learning, which is a sub-part of artificial
intelligence, demonstrates considerable potential to
address this need. Its ability to grasp patterns from large
datasets and forecast future events renders it well-suited
for the task of predicting potential cardiovascular
diseases. This enables early intervention and
preventative strategies. This academic review explores
various scholarly literature applying diverse machine
learning algorithms - including k-nearest neighbours
(classifies new data points based on majority), decision
trees (tree-like model to split dataset into smaller
datasets), random forests (ensemble learning method),
logistic and linear regression (used for classification and
regression respectively), and support vector machines
(differentiates datasets by maximizing the margin
between them) - to the realm of heart disease risk
modelling. Algorithms are educated with reputable
datasets from sources such as the Cleveland Clinic,
Hungarian, Swiss, Long Beach and UCI repositories. By
comprehensively surveying achievements to date, this
review aims to outline progress made in machine
learning for cardiovascular prognosis. Advancing
predictive accuracy through iterative research brings
closer the goal of personalized heart health monitoring
to preserve life and promote community wellness.
Further research holds promise to transform
cardiovascular prevention through precision machine
learning.
Cardiovascular diseases remain a leading global cause of
mortality as per the World Health Organization which
estimates 12 million deaths annually. Often referred to as
heart diseases, accurate and early diagnosis of these
conditions is significant in better prevention and treatment.
However, traditional diagnostic methods are often very
time-consuming and costly. Recent advancements in
machine learning (ML) have prompted researchers to
explore its potential for predicting heart disease, offering a
non-invasive and possibly more efficient approach. This
literature review examines the emerging field of ML
applications in heart disease prediction. We conduct a
systematic analysis of numerous research papers, evaluating
the diverse ML algorithms and techniques employed across
studies.
This review examines algorithm diversity, performance
comparison, challenges and limitations, and future scope in
machine learning (ML) - based heart disease prediction.
Algorithm diversity analyses a range of ML techniques,
including deep learning, support vector machines, logistic
regression, and ensemble learning. Performance
comparison assesses algorithm accuracy, sensitivity,
specificity, and other metrics to identify promising
approaches. Challenges and limitations address issues like
data quality, bias, and interpretability. Future directions
highlight potential avenues to advance ML-based
prediction. Through critical analysis, this review aims to
provide insights on ML's potential and challenges in
revolutionizing early heart disease diagnosis and
management. It functions as an asset for clinicians,
researchers, and healthcare professionals.

Keywords—decision tree, heart disease, KNN, logistic

regression, support vector machine, random forest.
 II. LOGISTIC REGRESSION generated during ECG exams provides insights into cardiac
functioning. The ‘P’ wave signifies atrial depolarization,
the ‘QRS’ complex indicates ventricular depolarization,
Logistic regression, a machine learning algorithm, is and the ‘T’ wave is linked to ventricular repolarization.
applied to address classification problems with binary Together, examination of these distinct deflections’ aids in
outcomes. It predicts the probability of a specific event evaluation of atrial and ventricular conduction as well as
happening based on various factors and outputs values myocardial repolarization. Deviations from normal wave
between 0 and 1, representing the likelihood of the patterns can indicate underlying pathologies such as
event occurring. It also classifies data points into two arrhythmias, conduction delays, or ischemia. By
incorporating ECG-derived features into predictive
categories based on a threshold (e.g., 0.5).
modelling, researchers hope to diagnose cardiac conditions
Analysis of cardiac disease typically involves several more accurately and better stratify patient risk. Overall, the
inclusion of variables representing ECG waveform
key steps. Data acquisition utilizes appropriate
components allows algorithms to leverage the physiological
methods to collect relevant medical information.
insights obtainable from electrographic assessment of the
Preprocessing then cleanses the data by removing heart.
errors or inconsistencies. Feature selection identifies
attributes that are highly correlated with the target
variable of disease presence/absence. Logistic
regression modelling commonly trains and tests on
these features to predict whether cardiac disease is
present or not. This established workflow first gathers
suitable input, prepares the data, focuses on impactful
predictors, and finally applies a standard classification
algorithm to determine cardiac disease status. Overall,
the approach aims to methodically analyse cardiac
conditions through established machine learning
techniques.

Fig. 2. An Electrocardiogram [2]

Logistic regression (LR), a supervised machine learning

classification purposes, is used when the dependent variable
is binary or dichotomous. LR can predict discrete
categorical variables that have two possible classes, such as
0 or 1. It can be represented using the sigmoid function
which is serves as the cost function in LR. The sigmoid
transforms the predicted real values into probabilities
within the range 0 and 1.

The logistic sigmoid function is:

1
𝑃(𝑥) =
1+𝑒

Where P(x) represents the probability estimation function

whose range is from 0 to 1. The variable x is the input to the
probability function, which is the algorithm's predictive
value. Additionally, e is Euler's number, which has a value
of approximately 2.71828.

Fig. 1. Workflow of logistic regression model [1]

The datasets utilized for heart disease prediction contain

variables representing waves observed in electrocardiogram
(ECG) readings. The characteristic waveform morphology
 III. LITERATURE SURVEY
[3] Alkayyali, Z. K. & et al., (2023) provides a
comprehensive review of 40 studies employing machine
learning techniques for the prediction of heart diseases. The
authors used systematic learning techniques with CNN
being the most prevalent, achieving accuracy exceeding
88%. Showed how important is the need for a diverse
dataset. Suggested future scope studies in the under-
explored techniques like reinforcement learning and semi-
supervised learning with more diverse datasets to improve
model generalizability.
[4] Bhatt, C. M. & et al., (2023) shows how the machine
learning algorithms are employed for heart disease
prediction have up to 94% accuracy. However, all the
studies which the author mentions have used small sample
sizes, and the results of those studies cannot be generalized
for the larger populations also. In this paper, the authors
have converted the continuous data into categorical data
which improves the accuracy of the machine learning
algorithms. However, this is not the only approach, every
method depends on the specific dataset and the machine
learning algorithm used. The authors made use of the
following machine learning algorithms – random forests
(that combines various decision trees to improve accuracy),
decision trees (that are used to classify data into different
categories), and vector machines (that are used for
classification and regression).
[5] Gupta, C. & et al., (2022) in their paper stated that they
used supervise machine learning algorithms employed for
prediction of heart diseases with high precision. However,
there is no one-size-fits-all approach for everything,
different algorithms work in different datasets. Logistic
regression, which is a type of machine learning algorithm,
is commonly employed for classification tasks. It has been
shown to be effective for predicting cardiac disease in
several studies. Other machine learning algorithms that the
authors have used to predict cardiac diseases include
random forest, random forests, and support vector
machines.
[6] Rahman, M. M. & et al., (2022) the paper discusses a
website based cardiac disease prediction system employing
machine learning algorithms. The system uses 13 health
parameters which have been shown to be effective to
predict heart disease in other studies. The system also uses
eight machine learning algorithms to make predictions. The
results show that decision trees and random forests provide
the best precision and effectiveness in the prediction of
heart diseases. The system is hosted on a website so that the
people can check their heart condition from anywhere.
[7] Hasanova, H. & et al., (2022) proposed the use of
blockchain technology in the machine learning algorithm
framework to enhance the heart disease prediction. It
discusses that the traditional methods of storing and
analysing medical data are not secure or efficient. There is
a lack of transparency and accessibility to the patients
regarding their own data. The authors proposed the
blockchain based system which included decentralized data
storage and patients control over their data. The authors
introduced a machine learning technique called
SCA_WKNN for predicting heart disease, which leverages
the secure storage and transparency of blockchain
technology. This paper presents a novel application of
blockchain - using it to train a SCA_WKNN algorithm for
improved heart disease prediction.
[8] Rajendran, R. & et al., (2022) developed a new cutting-
edge way of a machine learning pipeline for enhancing the
accuracy in heart disease diagnosis through precision
prediction. The authors combined four datasets to increase
dataset volume and address bias-variance issues. Imputes
missing values and removes outliers based on attribute
relationships and mahala Nobis distance. Proposed a new
entropy-based feature engineering (EFE) technique for
improved data quality. Deployed a diverse ensemble of
machine learning models (Naive Bayes, decision trees,
SVMs, random forests, logistic regression) leveraging
various pre-processing and feature engineering techniques.
For accurate heart disease detection, an ensemble of
Logistic Regression and Naive Bayes demonstrated
superior performance compared to all other tested models,
reaching a stellar 96.8% accuracy and demonstrating high
specificity (92.7%), precision (91.5%), and overall
performance (0.931 F1 score).
[9] Absar, N. & et al., (2022) uses four machine learning
models (adaboost, KNN, random forest, decision tree) to
diagnosis heart diseases prediction. It combined and
analysed data from four sources (Switzerland, Cleveland,
Long Beach, Hungary). While achieving a remarkable
99.03% accuracy on the combined dataset, the system also
maintains a noteworthy 93.43% accuracy on the individual
Cleveland data, showcasing its effectiveness across
different datasets. The authors used Streamlit for building
the prediction system adds potential for wider accessibility
and ease of use.
[10] Sarra, R. R. & et al., (2022) introduces an innovative
cardiac disease prediction model based on the support
vector machine (SVM) algorithm, with the objective of
improving the precision and minimizing computation load.
Leveraging the power of X2 statistical feature selection, the
model's accuracy jumps to 89.47% on the Cleveland dataset
and 89.7% on Statlog, demonstrating the effectiveness of
this approach in optimizing prediction performance. The X2
method selects only 6 important features out of the 14,
reducing computational load and potentially improving
generalizability.
[11] Nagavelli, U. & et al., (2022) focuses on applying
machine learning techniques for enhanced detection and
precise heart disease prediction, particularly early-stage
heart failure (HFD). Existing research indicates the
potential of ML in disease diagnosis, highlighting various
techniques like SVM, XGBoost, and Naïve Bayes.
Challenges mentioned include limited large-scale and
diverse datasets for accurate model training and
interpretability difficulties with certain ML algorithms.
Future research directions include exploring under-utilized
techniques like DBSCAN and SMOTE-ENN for data
preparation and outlier handling and investigating more
diverse datasets to improve model generalizability.
[12] Raju, K. B. & et al. (2022) the paper explores the
investigation into heart disease diagnosis through
utilization of IoT and deep learning techniques and how it
suffers from limited accuracy or high computational cost.
The diagnosis process relied on an Optimized Cascaded
Convolutional Neural Network (CCNN), a specialized
architecture designed for enhanced accuracy. Its
hyperparameters were optimally configured using the
Galactic Swarm Optimization (GSO) algorithm.
Challenges identified include security and privacy
concerns, data complexity, and the need for effective
feature extraction and optimization techniques.
[13] Al Ahdal, A. & et al. (2022) investigates the potential
of utilizing machine learning for accurate heart disease
prediction through analysis of UCI medical datasets using
various machine learning algorithms. This study aims to
showcase on the best ML models employed for predicting
heart disease. The authors achieve this by comparing and
evaluating various models, validating their performance
with accuracy and confusion matrix analysis, and
optimizing efficiency through irrelevant attribute handling
and data normalization. The future work includes using
more advanced ML models and address the issue of data
privacy and security concerns.
[14] Sharean, T. M. & et al. (2022) reviews various deep
learning techniques and methods for prediction of heart
diseases. It highlights the potential of these methods for
early and accurate diagnosis, potentially leading to
improved patient outcomes. The deep learning approaches
include CNN-based method which extract features from
medical data (e.g., ECG signals) and achieve high accuracy
in predicting heart disease (up to 99.1%) and DNN-based
method which combine feature selection and deep learning
for efficient and reliable prediction (up to 98.77%).
Ensemble deep learning method combines multiple deep
learning models which further improves accuracy (up to
98.5%). The future direction is to explore more advanced
deep learning models like LSTMs and capsule
networks, transfer learning for limited data, and addressing
data privacy and security concerns.
[15] Ahsan, M. M. & et al. (2022) the paper focuses on the
challenges associated with imbalanced data in forecasting
cardiac disease through the application of machine learning
algorithms and deep learning methodologies. While these
methods show promise for early and accurate diagnosis,
their performance can be negatively impacted by
imbalanced datasets, where one class (e.g., healthy
individuals) dominates others (e.g., heart disease patients).
The authors conducted a systematic literature review (SLR)
of 451 research papers on heart disease diagnosis using
ML/DL. The study revealed several key findings such as
current research primarily focuses on improving model
performance, neglecting crucial aspects like interpretability
and explain ability, existing heart disease datasets often
contain imbalanced class ratios, leading to biased ML/DL
performance, various data-level and algorithm-level
techniques have been presented to deal with the imbalanced
data, but open challenges remain.
[16] Ahmad, G. N. & et al. (2022) proposes a system
utilizing diverse machine learning algorithms for cardiac
disease prediction. To achieve robust and comprehensive
heart disease prediction, the system employs a quartet of
powerful algorithms: Logistic Regression, Support Vector
Machine, K-Nearest Neighbours, and Gradient Boosting
Classifier. Each algorithm's potential is maximized through
GridSearchCV hyperparameter tuning, leading to rigorous
evaluation on two datasets: the Switzerland, Cleveland,
Long Beach V, and Hungary dataset and the UCI Kaggle
dataset. GridSearchCV played a pivotal role in unlocking
the full potential of the Extreme Gradient Boosting
Classifier, leading to exceptional accuracy across both
datasets. This dynamic duo achieved a perfect 100% testing
accuracy and a noteworthy 99.03% training accuracy on the
Cleveland et al. dataset, while securing a commendable
98.05% testing accuracy and a flawless 100% training
accuracy on the UCI Kaggle dataset. Standing tall among
its peers, the proposed system, powered by the Extreme
Gradient Boosting Classifier with GridSearchCV,
demonstrated its superiority in a head-to-head comparison
with established heart disease prediction techniques.
Remarkably, it achieved the highest testing accuracy,
leaving other methods in its wake.
[17] Chang, V. & et al. (2022) proposes an AI-based
detection system of cardiac diseases utilizing machine
learning algorithms created with the Python programming
language and its libraries. It describes the potential of
machine learning in heart disease risk. The paper mentions
Loku et al. (2020) highlighting Python's safety and
applications in healthcare. This paper adds value to the
domain by demonstrating the potential of Python-based
machine learning for heart disease detection and
introducing a random forest classifier approach with
promising accuracy.
[18] Ansarullah, S. I. & et al. (2022) suggests a heart
disease risk prediction model leveraging machine learning
techniques based on non-invasive factors like age, blood
pressure, BMI, and lifestyle habits. With a remarkable 85%
accuracy, the model not only delivers exceptional
performance but also stands out from the competition by
achieving superior prediction accuracy and a lower
misclassification rate. Specific findings in this paper
included that random forest achieved the best performance
among decision tree, K-nearest neighbour, support vector
machine, and Naive bayes algorithms and the model is
developed making use of a novel non-invasive dataset
collected from Kashmir, India. Limitations include
complex rules in the decision tree model and high
misclassification rates in K-nearest neighbour and Naive
Bayes models.
[19] Al Bataineh, A. & et al. (2022) proposes a new
technique for the prediction of cardiac diseases using a
swarm-based multilayer perceptron (MLP-PSO) network.
This method uses particle swarm optimization (PSO) to
optimize the training of the MLP neural network for
improving prediction accuracy. The authors compare their
method with 10 other machine learning algorithms and find
that it outperforms them all, achieving an accuracy of
84.61%. It highlights various studies that have utilized
different algorithms like Bayesian networks, decision trees,
K-Nearest Neighbours, and neural networks with varying
success. Future research could involve testing the method
on other datasets and exploring its integration into clinical
practice.
[20] Ali, M. M., & et al. (2021) investigated utilizing
machine learning for precisely predicting heart diseases at
a very early stage. They compared several supervised
learning algorithms on a heart diseases dataset from Kaggle
and various other sources and found that random forests
(RF) achieved the highest accuracy, sensitivity, and
specificity (all 100%). This proves that it doesn’t matter
how simple a machine learning algorithm is, it can be
effective for a particular dataset. The paper mentions the
importance of early-stage heart disease detection and the
potential of data mining techniques for improved diagnosis.
This paper explores previous research making use of data
mining for association rule extraction, classification, and
clustering.
IV. CONCLUSION
In conclusion, this study examined machine learning's
growing role in predicting cardiovascular disease through
an extensive analysis. Various algorithms were surveyed,
from established methods like logistic regression to modern
techniques such as deep learning and ensemble approaches.
These algorithms demonstrated differing levels of
effectiveness across datasets. While some promising
accuracy levels have been achieved, challenges remain
regarding data quality, bias, interpretability, necessitating
further research. Future areas of research include exploring
underutilized techniques, utilizing more comprehensive
and diverse datasets, and addressing ethical considerations
like data privacy and security. By advancing in these areas,
machine learning has great potential to revolutionize early
diagnosis and personalized intervention, ultimately
transforming the prevention and management of
cardiovascular disease.
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