An ECG-AI-Cox model combining ECG-based artificial intelligence with clinical risk factors outperformed clinical models for 10-year heart failure risk prediction (AUC 0.84 vs 0.78 for CPH).
Observational
Sí
Does an ECG-based AI model improve 10-year heart failure risk prediction compared to traditional clinical risk calculators?
An ECG-based AI model combined with clinical risk factors provides superior 10-year heart failure risk prediction compared to traditional clinical risk calculators.
Estimación del efecto: AUC 0.84
Tasa de eventos absoluta: 0.84% vs 0.78%
Background: Heart failure (HF) is a progressive condition with high global incidence. HF has two main subtypes: HF with preserved ejection fraction (HFpEF) and HF with reduced ejection fraction (HFrEF). There is an inherent need for simple yet effective electrocardiogram (ECG)-based artificial intelligence (AI; ECG-AI) models that can predict HF risk early to allow for risk modification. Objective: The main objectives were to validate HF risk prediction models using Multi-Ethnic Study of Atherosclerosis (MESA) data and assess performance on HFpEF and HFrEF classification. Methods: There were six models in comparision derived using ARIC data. 1) The ECG-AI model predicting HF risk was developed using raw 12-lead ECGs with a convolutional neural network. The clinical models from 2) ARIC (ARIC-HF) and 3) Framingham Heart Study (FHS-HF) used 9 and 8 variables, respectively. 4) Cox proportional hazards (CPH) model developed using the clinical risk factors in ARIC-HF or FHS-HF. 5) CPH model using the outcome of ECG-AI and the clinical risk factors used in CPH model (ECG-AI-Cox) and 6) A Light Gradient Boosting Machine model using 288 ECG Characteristics (ECG-Chars). All the models were validated on MESA. The performances of these models were evaluated using the area under the receiver operating characteristic curve (AUC) and compared using the DeLong test. Results: ECG-AI, ECG-Chars, and ECG-AI-Cox resulted in validation AUCs of 0.77, 0.73, and 0.84, respectively. ARIC-HF and FHS-HF yielded AUCs of 0.76 and 0.74, respectively, and CPH resulted in AUC = 0.78. ECG-AI-Cox outperformed all other models. ECG-AI-Cox provided an AUC of 0.85 for HFrEF and 0.83 for HFpEF. Conclusion: ECG-AI using ECGs provides better-validated predictions when compared to HF risk calculators, and the ECG feature model and also works well with HFpEF and HFrEF classification.
Butler et al. (Wed,) conducted a observational in Heart failure. ECG-AI-Cox model vs. Clinical risk models (ARIC-HF, FHS-HF, CPH) was evaluated on 10-year heart failure risk prediction (AUC) (AUC 0.84). An ECG-AI-Cox model combining ECG-based artificial intelligence with clinical risk factors outperformed clinical models for 10-year heart failure risk prediction (AUC 0.84 vs 0.78 for CPH).
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