TabulaTime: Novel multimodal deep learning for Acute Coronary Syndrome prediction through environmental and clinical data integration.

Abstract

Acute Coronary Syndromes (ACS), including ST- and non-ST-segment elevation myocardial infarction (STEMI, NSTEMI), remain a leading cause of global mortality. Traditional Cardiovascular Risk Scores (CVRS) provide important insights but mainly rely on clinical data, often neglecting environmental factors (e.g.air pollution, climate) that significantly influence cardiovascular health. Integrating complex time-series environmental and clinical datasets also presents substantial challenges. We propose TabulaTime, a multimodal deep learning framework integrating clinical risk factors with environmental data to enhance ACS risk prediction. TabulaTime delivers three innovations: multimodal integration of time-series environmental and clinical data; PatchRWKV for extracting complex temporal patterns with linear computational complexity; and enhanced interpretability through attention mechanisms. TabulaTime improves prediction accuracy by 20.5% over CatBoost, with environmental data contributing a 10.1% gain. PatchRWKV outperforms state-of-the-art models (MLP-, CNN-, RNN- and Transformer-based models). Feature analysis highlights key clinical and environmental predictors. This approach advances personalised prevention and strengthens public health against cardiovascular risks.