Arrhythmias & electrophysiology
ECG Signatures and Long-Term Ischemic Stroke Risk: A Deep Learning Analysis of 200,000 Patients
Authors' conclusion
ECG-based artificial intelligence (AI) can predict 10-year ischemic stroke with performance similar to a validated clinical score, possibly by encoding markers of abnormal atrial substrate linked to cardioembolism.
Study context
- Population
- Patients receiving longitudinal care at Massachusetts General Hospital (MGH), with external samples from Brigham and Women's Hospital (BWH) and Beth Israel Deaconess Medical Center (BIDMC)development n = 101,496
- Comparison
- ECG2Stroke vs revised Framingham Stroke Risk Profile
- Outcome
- Incident ischemic stroke: discrimination (AUC) and calibration (ICI)
- Follow-up
- 10 years
Methodological detailsdeep learning (convolutional neural network), external validation in 2 independent samples
- Deep learning (convolutional neural network)
- External validation in 2 independent samples
Performance
As reported in the abstract
10-year incident ischemic stroke, discrimination and calibration of ECG2Stroke
- AUC, MGH Test (n = 4,771)
- 0.795
- AUC, BWH (n = 68,884)
- 0.774
- AUC, BIDMC (n = 29,882)
- 0.772
- ICI, MGH Test
- 0.030
- ICI, BWH
- 0.005
- ICI, BIDMC
- 0.026
Further findings
| Outcome | Cause-specific HR (95% CI) | |
|---|---|---|
| Cardioembolic stroke · per 1-SD of logit-transformed probability | 2.17 (1.64–2.87) | |
| 0.20.5125Cause-specific hazard ratio (log scale) |
| Outcome | ECG2Stroke | FSRP | Estimate |
|---|---|---|---|
| 10-year AUC vs FSRP (patients with available data) | |||
| AUC MGH/BWH Test | 0.791 | 0.779 | |
| AUC BIDMC | 0.745 | 0.728 |
10-year AUC vs Framingham Stroke Risk Profile (FSRP) (patients with available data)
- ECG2Stroke similar to FSRP
Cardioembolic stroke
- Not associated with noncardioembolic stroke
Subgroups incl. with and without AF
- Stratification persisted across subgroups
Original publication
ECG Signatures and Long-Term Ischemic Stroke Risk: A Deep Learning Analysis of 200,000 Patients. J Am Coll Cardiol. Published 13 May 2026. doi:10.
Summarised from the published abstract; every number is checked against it