Application of the Artificial Intelligence Model for Detection of Electrocardiographic Signs of Coronary Occlusion in Patients with Non ST-Elevation Acute Coronary Syndrome

Keywords: coronary heart disease, myocardial infarction, unstable angina, percutaneous coronary intervention, coronary artery occlusion

Abstract

The aim. This study aimed to determine the effectiveness of the OMI AI deep learning model for the diagnosis of myocardial infarction in patients with non ST-elevation acute coronary syndrome.

Materials and methods. This single-center retrospective observational study analyzed the data of 238 patients admitted to the National Amosov Institute of Cardiovascular Surgery of the National Academy of Medical Sciences of Ukraine with a primary diagnosis of non ST-elevation acute coronary syndrome. The inclusion criteria for the study were: age ≥18 years, symptoms of acute coronary syndrome, at least one 10-second 12-lead electrocardiography on admission, no changes typical of ST-segment elevation myocardial infarction on electrocardiography, and at least one laboratory blood test for biomarkers of myocardial damage.

Results. The final analysis included data from 116 patients, 69 (59.5%) men and 47 (40.5%) women aged 43 to 88 years (mean age 67±11 years), of whom 34 were older patients (≥75 years). Of these, 29 (25%) patients were discharged with a diagnosis of acute myocardial infarction, 60 (51.7%) with a diagnosis of unstable angina, and 27 (23.3%) patients with other diagnoses. When analyzing electrocardiographic data by the OMI AI model, true positive results were obtained in 23 cases (19.8%), true negative results in 76 cases (65.5%), false positive results in 11 cases (9.5%), and false negative results in 6 cases (5%). Accordingly, the model’s sensitivity was 67% and specificity was 93%. The positive and negative predictive values for the model under study were 0.793 and 0.874, respectively. The accuracy of the model was 85.34% (95% CI: 77.78% to 90.64%).

Conclusions. The use of the artificial intelligence tools has the potential to improve the accuracy of diagnosis of myocardial infarction during hospitalization, accelerate the provision of specialized care and improve prognosis in patients with non ST-elevation acute coronary syndrome.

References

  1. Number of deaths by specific causes of death 2021. Kyiv: State Statistics Service of Ukraine; c2022 [cited 2024 Apr 13]. Available from: https://ukrstat.gov.ua/operativ/operativ2021/ds/kpops/arh_kpops2021_u.html
  2. Reports of the NHSU on the fulfillment of contracts for medical services under the medical guarantees program 2022. Kyiv: National Health Service of Ukraine; c2022 [cited 2024 Apr 13]. Available from: https://edata.e-health.gov.ua/e-data/zviti
  3. Byrne RA, Rossello X, Coughlan JJ, Barbato E, Berry C, Chieffo A, et al.; ESC Scientific Document Group. 2023 ESC Guidelines for the management of acute coronary syndromes. Eur Heart J. 2023;44(38):3720-3826. https://doi.org/10.1093/eurheartj/ehad191
  4. Bhatt DL, Lopes RD, Harrington RA. Diagnosis and Treatment of Acute Coronary Syndromes: A Review. JAMA. 2022;327(7):662-675. https://doi.org/10.1001/jama.2022.0358
  5. Haq IU, Chhatwal K, Sanaka K, Xu B. Artificial Intelligence in Cardiovascular Medicine: Current Insights and Future Prospects. Vasc Health Risk Manag. 2022;18:517-528. https://doi.org/10.2147/VHRM.S279337
  6. Somani S, Russak AJ, Richter F, Zhao S, Vaid A, Chaudhry F, et al. Deep learning and the electrocardiogram: review of the current state-of-the-art. Europace. 2021;23(8):1179-1191. https://doi.org/10.1093/europace/euaa377
  7. Siontis KC, Noseworthy PA, Attia ZI, Friedman PA. Artificial intelligence-enhanced electrocardiography in cardiovascular disease management. Nat Rev Cardiol. 2021;18(7):465-478. https://doi.org/10.1038/s41569-020-00503-2
  8. Herman R, Meyers HP, Smith SW, Demolder A, Bertolone DT, Leone A, et al. ECG-based deep learning for detecting epicardial coronary occlusion in acute myocardial infarction. Eur Heart J. 2023;44 Suppl 2:ehad655.2930. https://doi.org/10.1093/eurheartj/ehad655.2930
  9. Howie-Esquivel J, White M. Biomarkers in AcuteCardiovascular Disease. J Cardiovasc Nurs. 2008;23(2):124-131. https://doi.org/10.1097/01.JCN.0000305072.49613.92
  10. McErlean ES, Deluca SA, van Lente F, Peacock F 4th, Rao JS, Balog CA, et al. Comparison of troponin T versus creatine kinase-MB in suspected acute coronary syndromes. Am J Cardiol. 2000;85(4):421-426. https://doi.org/10.1016/s0002-9149(99)00766-3
  11. Herman R, Meyers HP, Smith SW, Bertolone DT, Leone A, Bermpeis K, et al. International evaluation of an artificial intelligence-powered electrocardiogram model detecting acute coronary occlusion myocardial infarction. Eur Heart J Digit Health. 2023;5(2):123-133. https://doi.org/10.1093/ehjdh/ztad074
Published
2024-06-27
How to Cite
Kalashnikov, S. A., Salo, S. V., Stepaniuk, A. V., Sandu, S., & Lazoryshynets, V. V. (2024). Application of the Artificial Intelligence Model for Detection of Electrocardiographic Signs of Coronary Occlusion in Patients with Non ST-Elevation Acute Coronary Syndrome. Ukrainian Journal of Cardiovascular Surgery, 32(2), 17-21. https://doi.org/10.30702/ujcvs/24.32(02)/KS025-1721