In European heart journal. Quality of care & clinical outcomes
AIMS : Prediction of adverse events in mid-term follow-up after transcatheter aortic valve implantation (TAVI) is challenging. We sought to develop and validate a machine learning model for prediction of 1-year all-cause mortality in patients who underwent TAVI and were discharged following the index procedure.
METHODS AND RESULTS : The model was developed on data of patients who underwent TAVI at a high-volume center between January 2013 and March 2019. Machine learning by extreme gradient boosting was trained and tested with repeated 10-fold hold-out testing using 34 pre- and 25 periprocedural clinical variables. External validation was performed on unseen data from two other independent high volume TAVI centers.Six hundred and four patients (43% men, 81 ± 5 years old, EuroSCORE II 4.8 [3.0-6.3]%) in the derivation and 823 patients (46% men, 82 ± 5 years old, EuroSCORE II 4.7 [2.9-6.0]%) in the validation cohort underwent TAVI and were discharged home following the index procedure. Over the 12 months of follow-up, 68 (11%) and 95 (12%) subjects died in the derivation and validation cohort respectively. In external validation the machine learning model had an area under the receiver-operator-curve of 0.82 (0.78-0.87) for prediction of 1-year all-cause mortality following hospital discharge after TAVI which was superior to pre- and periprocedural clinical variables including age 0.52 (0.46-0.59) and the EuroSCORE II 0.57 (0.51-0.64), p < 0.001 for a difference.
CONCLUSION : Machine learning based on readily available clinical data allows accurate prediction of 1-year all-cause mortality following a successful TAVI.
Kwiecinski Jacek, Dabrowski Maciej, Nombela-Franco Luis, Grodecki Kajetan, Pieszko Konrad, Chmielak Zbigniew, Pylko Anna, Hennessey Breda, Kalinczuk Lukasz, Tirado-Conte Gabriela, Rymuza Bartosz, Kochman Janusz, Opolski Maksymilian P, Huczek Zenon, Dweck Marc R, Dey Damini, Jimenez-Quevedo Pilar, Slomka Piotr, Witkowski Adam
2023-Jan-13
Aortic stenosis, Artificial intelligence, Machine learning, Transcatheter aortic valve implantation
