An AI-derived ECG age gap of ≥7 years was associated with an increased risk of new-onset atrial fibrillation across four multinational cohorts (HRs ranging from 1.76 to 2.50).
Cohort (n=1,020,433)
Yes
Does AI-derived electrocardiographic aging (age gap ≥ 7 years) predict the risk of new- and early-onset atrial fibrillation compared to a normal age gap?
AI-derived ECG aging (an age gap of ≥7 years between AI-predicted and chronological age) is significantly associated with an increased risk of new- and early-onset atrial fibrillation across diverse multinational cohorts.
Effect estimate: HR 1.76-2.50
BACKGROUND AND AIMS: Artificial intelligence (AI) algorithms in 12-lead electrocardiogram (ECG) provides promising age prediction methods. This study investigated whether the discrepancy between ECG-derived AI-predicted age (AI-ECG age) and chronological age, termed electrocardiographic aging (ECG aging), is associated with atrial fibrillation (AF) risk. METHODS: An AI-ECG age prediction model was developed using a large-scale dataset (1 533 042 ECGs from 689 639 participants) and validated with six independent and multi-national datasets (737 133 ECGs from 330 794 participants). The AI-ECG age gap was calculated across two South Korean cohorts mean (standard deviation) follow-up: 4.1 (4.3) years for 111 483 participants and 6.1 (3.8) years for 37 517 participants, one UK cohort 3.0 (1.6) years; 40 973 participants, and one US cohort 12.9 (8.6) years; 90 639 participants. Participants were classified into two groups: normal group (age gap < 7 years) and ECG-aged group (age gap ≥ 7 years). The predictive capability of ECG aging for new- and early-onset AF risk was assessed. RESULTS: The mean AI-ECG ages were 51.9 (16.2), 47.4 (12.5), 68.4 (7.8), and 56.7 (14.6) years with age gaps of .0 (6.8), -.1 (6.0), 4.7 (8.7), and -1.4 (8.9) years in the two South Korean, UK, and US cohorts, respectively. In the ECG-aged group, increased risks of new-onset AF were observed with hazard ratios (95% confidence intervals) of 2.50 (2.24-2.78), 1.89 (1.46-2.43), 1.90 (1.55-2.33), and 1.76 (1.67-1.86) in the two South Korean, UK, and US cohorts, respectively. For early-onset AF, odds ratios were 2.89 (2.47-3.37), 1.94 (1.39-2.70), 1.58 (1.06-2.35), and 1.79 (1.62-1.97) in these cohorts compared with the normal group. CONCLUSIONS: The AI-derived ECG aging was associated with the risk of new- and early-onset AF, suggesting its potential utility to identify individuals for AF prevention across diverse populations.
Cho et al. (Fri,) conducted a cohort in Atrial fibrillation (n=1,020,433). ECG-aged group (AI-ECG age gap ≥ 7 years) vs. Normal group (age gap < 7 years) was evaluated on New-onset atrial fibrillation (HR 1.76-2.50). An AI-derived ECG age gap of ≥7 years was associated with an increased risk of new-onset atrial fibrillation across four multinational cohorts (HRs ranging from 1.76 to 2.50).