CIN-RiskNet: a dynamic feature-enhanced TabTransformer with hybrid SMOTE-noise augmentation for contrast-induced nephropathy prediction.

PURPOSE: To propose a dynamic feature-enhanced TabTransformer framework that providing a more effective and accurate tool for predicting Contrast-Induced Nephropathy (CIN). METHODS: This study proposes CIN-RiskNet, a dynamic feature-enhanced TabTransformer model integrated with a hybrid SMOTE-Noise augmentation strategy. The approach includes adaptive feature gating to suppress noise, synthetic minority oversampling to address class imbalance, and multi-head self-attention to capture complex feature interactions. The model was trained and evaluated under a leakage-free stratified five-fold cross-validation protocol, where SMOTE and Gaussian noise were applied only to the training split within each fold trained on a clinical dataset from Tianjin University Chest Hospital that including a total of 1,679 patients who underwent percutaneous coronary intervention for coronary heart disease. RESULTS: Under leakage-free five-fold evaluation, CIN-RiskNet achieved strong performance with an accuracy of 95.40%, a recall of 95.40%, and an F1-score of 95.42%. It attained the highest F1-score and recall among all evaluated configurations. It outperformed not only traditional machine learning models including XGBoost, Random Forest, and Support Vector Machine, but also the Mehran risk score, a widely used clinical scoring system for CIN prediction. Ablation studies confirmed the contributions of each module, demonstrating improved robustness and generalization. CONCLUSION: The proposed model effectively addresses key challenges in CIN prediction, including class imbalance and feature noise, through an integrated deep learning framework. It shows promising potential as a decision-support tool, while external multicenter validation remains necessary before broad clinical deployment.