Key result
Artificial neural network predicts CMVO during emergency PCI in MI patients with ~97% NPV.
Why the study?
The study was designed to develop, evaluate, and validate an artificial neural network to predict coronary microvascular obstruction during PCI in MI patients using parameters routinely available in an operating room.
Can an artificial neural network predict coronary microvascular obstruction during emergency PCI in patients with myocardial infarction?
Observational (n=5,621)
No
Can an artificial neural network predict coronary microvascular obstruction during emergency PCI in patients with myocardial infarction?
An artificial neural network using routinely available parameters can predict coronary microvascular obstruction during emergency PCI with high negative predictive value but low positive predictive value.
High NPV may aid ruling out obstruction in MI; leaves open prospective validation of neural networks before clinical use.
was to develop, evaluate, and validate an artificial neural network to predict coronary microvascular obstruction (CMVO) during percutaneous coronary interventions (PCI) in patients with myocardial infarctions (MI) based on the parameters, which are routinely available in an operating room when choosing a surgical approach. Materials and Methods: 5621 patients with MI and emergency PCI were retrospectively selected from the database of the City Clinical Hospital No.13 (Nizhny Novgorod, Russia); among them, there were 3935 men (70%) and 1686 women (30%), their mean age was 61.5±10.8 years. CMVO was recorded in 201 (4%) patients (the blood flow in the infarction-related artery after PCI was less than 3 points according to TIMI flow grade). The following input parameters were assessed: age, gender, past history of coronary artery disease, previous revascularization, presence of ST-segment elevation, a class of acute heart failure, a fact of systemic thrombolytic therapy administration and its effectiveness, symptom-to-balloon time, severity of coronary thrombosis and atherosclerosis, the number of stents and the number of operated coronary arteries. The sampling was divided into a training group (n=4060), a testing group (n=717), and an independent validation group (n=844). Results: We developed an artificial neural network by a fully connected multilayer perception with forward signal propagation and two hidden layers (the area under the ROC curve - 0.69) to predict CMVO based on the subsampling for training and testing. The network model was tested on an independent subsampling (the area under the ROC curve - 0.64, negative predictive value - 97.4%, positive predictive value - 14.6%). Conclusion: The developed artificial neural network enables to use the parameters routinely available in an operating room when choosing a surgical approach and predict CMVO development during PCI in MI patients with accuracy sufficient for practical use.
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Фролов et al. (2021) conducted an observational in Myocardial infarction (n=5,621). Artificial neural network was evaluated on Prediction of coronary microvascular obstruction (CMVO) (AUC 0.64). An artificial neural network predicted coronary microvascular obstruction during emergency PCI in MI patients with an area under the ROC curve of 0.64, NPV of 97.4%, and PPV of 14.6%.
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