Coronary disease & ACS

Deep learning electrocardiogram model for risk stratification of coronary revascularization need in the emergency department

Eur Heart JPublished Diagnostic accuracy study

Authors' conclusion

The model was able to detect revascularization and Type 1 MI with competitive performance, suggesting a potential role to complement current clinical assessment.

Study context

Population
ED visits; US cohort (training/test) and European external validation cohorttest n = 35,995
Comparison
Deep learning electrocardiogram (ECG) model vs clinician ECG interpretation and cardiac troponin T
Outcome
AUROC for coronary revascularization
Methodological detailsexternal validation, Trained on 144 691 US ED visits
  • External validation
  • Trained on 144 691 US ED visits

Performance

As reported in the abstract

Revascularization, test cohort
Test or modelAUC
ECG model0.91 (95% CI 0.91-0.91)
Clinician ECG interpretation0.65 (95% CI 0.54-0.76)
Troponin T (TnT)0.71

AUC

ECG model0.91 (95% CI 0.91-0.91)
Clinician ECG interpretation0.65 (95% CI 0.54-0.76)
Troponin T (TnT)0.71

Further findings

OutcomeECG modelClinician ECG interpretationTnT
External validation (Europe, n = 18 673)
AUC revascularization0.81 (95% CI 0.81-0.82)0.70 (95% CI 0.57-0.83)— not stated in the abstract
AUC Type 1 MI0.85 (95% CI 0.84-0.85)0.74 (95% CI 0.56-0.92)— not stated in the abstract
AUC revascularization (hs-TnT)— not stated in the abstract— not stated in the abstract0.85
AUC Type 1 MI (hs-TnT)— not stated in the abstract— not stated in the abstract0.87

— not stated in the abstract

External validation (Europe, n = 18 673)

ECG model had higher specificity but lower sensitivity vs hs-TnT

Original publication

Deep learning electrocardiogram model for risk stratification of coronary revascularization need in the emergency department. Eur Heart J. Published 29 March 2025. doi:10.1093/eurheartj/ehaf254

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