1-Year Mortality Prediction through Artificial Intelligence Using Hemodynamic Trace Analysis among Patients with ST Elevation Myocardial Infarction.

Autor:	Razavi SR; Biomedical Engineering Program, University of Manitoba, Winnipeg, MB R3T 5V6, Canada., Szun T; Department of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB R3E 3P5, Canada., Zaremba AC; Department of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB R3E 3P5, Canada., Shah AH; Department of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB R3E 3P5, Canada., Moussavi Z; Biomedical Engineering Program, University of Manitoba, Winnipeg, MB R3T 5V6, Canada.
Jazyk:	angličtina
Zdroj:	Medicina (Kaunas, Lithuania) [Medicina (Kaunas)] 2024 Mar 29; Vol. 60 (4). Date of Electronic Publication: 2024 Mar 29.
DOI:	10.3390/medicina60040558
Abstrakt:	Background and Objectives : Patients presenting with ST Elevation Myocardial Infarction (STEMI) due to occlusive coronary arteries remain at a higher risk of excess morbidity and mortality despite being treated with primary percutaneous coronary intervention (PPCI). Identifying high-risk patients is prudent so that close monitoring and timely interventions can improve outcomes. Materials and Methods : A cohort of 605 STEMI patients [64.2 ± 13.2 years, 432 (71.41%) males] treated with PPCI were recruited. Their arterial pressure (AP) wave recorded throughout the PPCI procedure was analyzed to extract features to predict 1-year mortality. After denoising and extracting features, we developed two distinct feature selection strategies. The first strategy uses linear discriminant analysis (LDA), and the second employs principal component analysis (PCA), with each method selecting the top five features. Then, three machine learning algorithms were employed: LDA, K-nearest neighbor (KNN), and support vector machine (SVM). Results : The performance of these algorithms, measured by the area under the curve (AUC), ranged from 0.73 to 0.77, with accuracy, specificity, and sensitivity ranging between 68% and 73%. Moreover, we extended the analysis by incorporating demographics, risk factors, and catheterization information. This significantly improved the overall accuracy and specificity to more than 76% while maintaining the same level of sensitivity. This resulted in an AUC greater than 0.80 for most models. Conclusions : Machine learning algorithms analyzing hemodynamic traces in STEMI patients identify high-risk patients at risk of mortality. Competing Interests: The authors declare no conflicts of interest.
Databáze:	MEDLINE
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