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Deep-learning-based risk stratification for mortality of patients with acute myocardial infarction

Author

Listed:
  • Joon-myoung Kwon
  • Ki-Hyun Jeon
  • Hyue Mee Kim
  • Min Jeong Kim
  • Sungmin Lim
  • Kyung-Hee Kim
  • Pil Sang Song
  • Jinsik Park
  • Rak Kyeong Choi
  • Byung-Hee Oh

Abstract

Objective: Conventional risk stratification models for mortality of acute myocardial infarction (AMI) have potential limitations. This study aimed to develop and validate deep-learning-based risk stratification for the mortality of patients with AMI (DAMI). Methods: The data of 22,875 AMI patients from the Korean working group of the myocardial infarction (KorMI) registry were exclusively divided into 12,152 derivation data of 36 hospitals and 10,723 validation data of 23 hospitals. The predictor variables were the initial demographic and laboratory data. The endpoints were in-hospital mortality and 12-months mortality. We compared the DAMI performance with the global registry of acute coronary event (GRACE) score, acute coronary treatment and intervention outcomes network (ACTION) score, and the thrombolysis in myocardial infarction (TIMI) score using the validation data. Results: In-hospital mortality for the study subjects was 4.4% and 6-month mortality after survival upon discharge was 2.2%. The areas under the receiver operating characteristic curves (AUCs) of the DAMI were 0.905 [95% confidence interval 0.902–0.909] and 0.870 [0.865–0.876] for the ST elevation myocardial infarction (STEMI) and non ST elevation myocardial infarction (NSTEMI) patients, respectively; these results significantly outperformed those of the GRACE (0.851 [0.846–0.856], 0.810 [0.803–0.819]), ACTION (0.852 [0.847–0.857], 0.806 [0.799–0.814] and TIMI score (0.781 [0.775–0.787], 0.593[0.585–0.603]). DAMI predicted 30.9% of patients more accurately than the GRACE score. As secondary outcome, during the 6-month follow-up, the high risk group, defined by the DAMI, has a significantly higher mortality rate than the low risk group (17.1% vs. 0.5%, p

Suggested Citation

  • Joon-myoung Kwon & Ki-Hyun Jeon & Hyue Mee Kim & Min Jeong Kim & Sungmin Lim & Kyung-Hee Kim & Pil Sang Song & Jinsik Park & Rak Kyeong Choi & Byung-Hee Oh, 2019. "Deep-learning-based risk stratification for mortality of patients with acute myocardial infarction," PLOS ONE, Public Library of Science, vol. 14(10), pages 1-15, October.
    • Handle: RePEc:plo:pone00:0224502
    DOI: 10.1371/journal.pone.0224502
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    1. Calcagno, Vincent & de Mazancourt, Claire, 2010. "glmulti: An R Package for Easy Automated Model Selection with (Generalized) Linear Models," Journal of Statistical Software, Foundation for Open Access Statistics, vol. 34(i12).
    2. Andre Esteva & Brett Kuprel & Roberto A. Novoa & Justin Ko & Susan M. Swetter & Helen M. Blau & Sebastian Thrun, 2017. "Dermatologist-level classification of skin cancer with deep neural networks," Nature, Nature, vol. 542(7639), pages 115-118, February.
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    1. Sazzli Kasim & Putri Nur Fatin Amir Rudin & Sorayya Malek & Firdaus Aziz & Wan Azman Wan Ahmad & Khairul Shafiq Ibrahim & Muhammad Hanis Muhmad Hamidi & Raja Ezman Raja Shariff & Alan Yean Yip Fong & , 2024. "Data analytics approach for short- and long-term mortality prediction following acute non-ST-elevation myocardial infarction (NSTEMI) and Unstable Angina (UA) in Asians," PLOS ONE, Public Library of Science, vol. 19(2), pages 1-28, February.

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