Cardiovascular events and artificial intelligence-predicted age using 12-lead electrocardiograms. (February 2023)

• Record Type: Journal Article
• Authors: Hirota, Naomi; Suzuki, Shinya; Motogi, Jun; Nakai, Hiroshi; Matsuzawa, Wataru; Takayanagi, Tsuneo; Umemoto, Takuya; Hyodo, Akira; Satoh, Keiichi; Arita, Takuto; Yagi, Naoharu; Otsuka, Takayuki; Yamashita, Takeshi
• Is Part Of: IJC heart & vasculature. Volume 44(2023)
• Publication Date: 2023-02
• Subjects: Electrocardiogram -- Biological age -- Cardiovascular event -- Artificial intelligence; Cardiovascular system -- Diseases -- Periodicals; Cardiovascular system -- Pathophysiology -- Periodicals; 616.1005
• DOI: 10.1016/j.ijcha.2023.101172
• Languages: English
• ISSNs: 2352-9067

Abstract

Abstract: Background: There is increasing evidence that 12-lead electrocardiograms (ECG) can be used to predict biological age, which is associated with cardiovascular events. However, the utility of artificial intelligence (AI)-predicted age using ECGs remains unclear. Methods: Using a single-center database, we developed an AI-enabled ECG using 17 042 sinus rhythm ECGs (SR-ECG) to predict chronological age (CA) with a convolutional neural network that yields AI-predicted age. Using the 5-fold cross validation method, AI-predicted age deriving from the test dataset was yielded for all ECGs. The incidence by AgeDiff and the areas under the curve by receiver operating characteristic curve with AI-predicted age for cardiovascular events were analyzed. Results: During the mean follow-up period of 460.1 days, there were 543 cardiovascular events. The annualized incidence of cardiovascular events was 2.24 %, 2.44 %, and 3.01 %/year for patients with AgeDiff < −6, −6 to ≤6, and >6 years, respectively. The areas under the curve for cardiovascular events with CA and AI-predicted age, respectively, were 0.673 and 0.679 (Delong's test, P = 0.388) for all patients; 0.642 and 0.700 (P = 0.003) for younger patients (CA < 60 years); and 0.584 and 0.570 (P = 0.268) for older patients (CA ≥ 60 years). Conclusions: AI-predicted age using 12-lead ECGs showed superiority in predicting cardiovascular events compared with CA in younger patients, but not in older patients.