In a new study from the Johns Hopkins Hospital, researchers found a novel artificial intelligence score provides a more accurate forecast of the likelihood of patients with suspected or known coronary artery disease dying within 10 years.
Unlike traditional methods based on clinical data, the new score also includes imaging information on the heart, measured by stress cardiovascular magnetic resonance (CMR).
“Stress” refers to the fact that patients are given a drug to mimic the effect of exercise on the heart while in the magnetic resonance imaging scanner.
In the study, the team tested 31,752 patients referred for stress CMR between 2008 and 2018 to a center in Paris because of chest pain, shortness of breath on exertion, or high risk of cardiovascular disease but no symptoms.
High risk was defined as having at least two risk factors such as hypertension, diabetes, dyslipidaemia, and current smoking. The average age was 64 years and 66% were men.
Patients were followed up for a median of six years.
Machine learning was conducted in two steps. First, it was used to select which of the clinical and CMR parameters could predict death and which could not.
Second, machine learning was used to build an algorithm based on the important parameters identified in step one, allocating different emphasis to each to create the best prediction.
The team found the machine learning score was able to predict which patients would be alive or dead with 76% accuracy (in statistical terms, the area under the curve was 0.76).
Using the same data, the researchers calculated the 10-year risk of all-cause death.
The machine learning score had a much higher area under the curve for the prediction of 10-year all-cause mortality compared with the other scores.
The team says stress CMR is a safe technique that does not use radiation.
Patients with chest pain, dyspnoea, or risk factors for heart disease should undergo a stress CMR exam and have their score calculated.
This would enable us to provide more intense follow-up and advice on exercise, diet, and so on to those in greatest need.
If you care about heart disease, please read studies about one cup of these vegetables a day can lower heart disease risk, and findings that scientists find the cause of genetic risk of heart disease.
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The study is presented at EuroEcho 2021. One author of the study is Dr. Theo Pezel.
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