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Association Between Electrocardiographic Age and Cardiovascular Events in Community Settings : The Framingham Heart Study
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- Brant, Luisa C. C. (author)
- Univ Fed Minas Gerais, Fac Med, Belo Horizonte, Brazil.;Univ Fed Minas Gerais, Hosp Clin, Telehlth Ctr, Belo Horizonte, Brazil.
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- Horta Ribeiro, Antônio (author)
- Uppsala universitet,Institutionen för informationsteknologi
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- Pinto-Filho, Marcelo M. (author)
- Univ Fed Minas Gerais, Hosp Clin, Telehlth Ctr, Belo Horizonte, Brazil.
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- Kornej, Jelena (author)
- Boston Med Ctr, Sect Cardiovasc Med, Boston, MA USA. Boston Univ, Chobanian & Avedisian Sch Med, Boston, MA USA. Univ Massachusetts, Chan Med Sch, Dept Med, Worcester, MA USA.
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- Preis, Sarah R. (author)
- Boston Univ, Sch Publ Hlth, Dept Biostat, Framingham, MA USA.
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- Fetterman, Jessica L. (author)
- Boston Med Ctr, Evans Dept Med, Boston, MA USA.;Whitaker Cardiovasc Inst, , USABoston, Boston, MA USA.
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Eromosele, Oseiwe B. (author)
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- Magnani, Jared W. (author)
- Univ Pittsburgh, Ctr Res Hlth Care, Dept Med, Pittsburgh, PA USA.
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- Murabito, Joanne M. (author)
- Boston Univ, Sch Publ Hlth, MA Framingham Heart Study, Framingham, MA USA.;Boston Med Ctr, Sect Gen Internal Med, Boston, MA USA.
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- Larson, Martin G. (author)
- Boston Univ, Sch Publ Hlth, Dept Biostat, Framingham, MA USA.;Boston Univ, Sch Publ Hlth, MA Framingham Heart Study, Framingham, MA USA.
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- Benjamin, Emelia J. (author)
- Boston Univ, Sch Publ Hlth, Dept Epidemiol, Framingham, MA USA.;Boston Univ, Sch Publ Hlth, MA Framingham Heart Study, Framingham, MA USA.;Boston Med Ctr, Sect Cardiovasc Med, Boston, MA USA. Boston Univ, Chobanian & Avedisian Sch Med, Boston, MA USA. Univ Massachusetts, Chan Med Sch, Dept Med, Worcester, MA USA.
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- Ribeiro, Antonio L. P. (author)
- Univ Fed Minas Gerais, Fac Med, Belo Horizonte, Brazil.;Univ Fed Minas Gerais, Hosp Clin, Telehlth Ctr, Belo Horizonte, Brazil.
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- Lin, Honghuang (author)
- Univ Massachusetts, Chan Med Sch, Dept Med, 55 Lake Ave N, S6-755, Worcester 01655, MA USA.
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Univ Fed Minas Gerais, Fac Med, Belo Horizonte, Brazil;Univ Fed Minas Gerais, Hosp Clin, Telehlth Ctr, Belo Horizonte, Brazil. Institutionen för informationsteknologi (creator_code:org_t)
- Ovid Technologies (Wolters Kluwer Health), 2023
- 2023
- English.
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In: Circulation. Cardiovascular Quality and Outcomes. - : Ovid Technologies (Wolters Kluwer Health). - 1941-7713 .- 1941-7705. ; 16:7
- Related links:
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https://urn.kb.se/re...
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https://doi.org/10.1...
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Abstract
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- BACKGROUND: Deep neural networks have been used to estimate age from ECGs, the electrocardiographic age (ECG-age), which predicts adverse outcomes. However, this prediction ability has been restricted to clinical settings or relatively short periods. We hypothesized that ECG-age is associated with death and cardiovascular outcomes in the long-standing community-based FHS (Framingham Heart Study).METHODS: We tested the association of ECG-age with chronological age in the FHS cohorts in ECGs from 1986 to 2021. We calculated the gap between chronological and ECG-age (& UDelta;age) and classified individuals as having normal, accelerated, or decelerated aging, if & UDelta;age was within, higher, or lower than the mean absolute error of the model, respectively. We assessed the associations of & UDelta;age, accelerated and decelerated aging with death or cardiovascular outcomes (atrial fibrillation, myocardial infarction, and heart failure) using Cox proportional hazards models adjusted for age, sex, and clinical factors.RESULTS:The study population included 9877 FHS participants (mean age, 55 & PLUSMN;13 years; 54.9% women) with 34 948 ECGs. ECG-age was correlated to chronological age (r=0.81; mean absolute error, 9 & PLUSMN;7 years). After 17 & PLUSMN;8 years of follow-up, every 10-year increase of & UDelta;age was associated with 18% increase in all-cause mortality (hazard ratio [HR], 1.18 [95% CI, 1.12-1.23]), 23% increase in atrial fibrillation risk (HR, 1.23 [95% CI, 1.17-1.29]), 14% increase in myocardial infarction risk (HR, 1.14 [95% CI, 1.05-1.23]), and 40% increase in heart failure risk (HR, 1.40 [95% CI, 1.30-1.52]), in multivariable models. In addition, accelerated aging was associated with a 28% increase in all-cause mortality (HR, 1.28 [95% CI, 1.14-1.45]), whereas decelerated aging was associated with a 16% decrease (HR, 0.84 [95% CI, 0.74-0.95]).CONCLUSIONS:ECG-age was highly correlated with chronological age in FHS. The difference between ECG-age and chronological age was associated with death, myocardial infarction, atrial fibrillation, and heart failure. Given the wide availability and low cost of ECG, ECG-age could be a scalable biomarker of cardiovascular risk.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kardiologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cardiac and Cardiovascular Systems (hsv//eng)
Keyword
- artificial intelligence
- atrial fibrillation
- cardiovascular diseases
- electrocardiogram
- heart failure
- myocardial infarction
- risk factors
Publication and Content Type
- ref (subject category)
- art (subject category)
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Brant, Luisa C. ...
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Horta Ribeiro, A ...
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Pinto-Filho, Mar ...
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Kornej, Jelena
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Preis, Sarah R.
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Fetterman, Jessi ...
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Eromosele, Oseiw ...
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Magnani, Jared W ...
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Murabito, Joanne ...
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Larson, Martin G ...
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Benjamin, Emelia ...
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Ribeiro, Antonio ...
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Lin, Honghuang
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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Circulation. Car ...
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Uppsala University