Scientific Sessions 2024  /  AI at Heart: Revolutionizing Cardiovascular Imaging  /  Incorporating AI-enabled Left Atrial Volume Measurement from Coronary Artery Calcium Scans (AI-CAC) to CHA2DS2s-VASc Risk Score Improves Stroke Prediction in the Asymptomatic Population: The Multi-Ethnic Study of Atherosclerosis
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American Heart Association

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Final ID: Su3048

Incorporating AI-enabled Left Atrial Volume Measurement from Coronary Artery Calcium Scans (AI-CAC) to CHA2DS2s-VASc Risk Score Improves Stroke Prediction in the Asymptomatic Population: The Multi-Ethnic Study of Atherosclerosis

Abstract Body (Do not enter title and authors here):
Background: The CHA2DS2-VASc risk score is a clinical tool for stroke prediction. It is mainly used in patients with atrial fibrillation (AF) but is also applied to the non-AF population. We previously reported that artificial intelligence (AI)-enabled left atrial (LA) volumetry from coronary artery calcium (CAC) scans (AI-CAC) predicts AF as early as one year and outperformed CHARGE-AF and NT-proBNP. In this report, we compare AI-CAC LA volumetry to the CHA2DS2-VASc risk score and evaluate the incremental value of incorporating AI-CAC LA volume to CHA2DS2-VASc for incident stroke prediction in the non-AF population.
Methods: We applied the AutoChamberTM LA volumetry component of AI-CAC to CAC scans of 5830 people without AF (52.2% women, age 61.7±10.2 years) enrolled in the Multi-Ethnic Study of Atherosclerosis (MESA) baseline (2000-2002). We used the 15-year outcomes data for incident stroke (ischemic and hemorrhagic) and assessed discrimination using the time-dependent area under the curve (AUC) between AI-CAC LA volume vs. CHA2DS2-VASc risk score. Notably, the CHA2DS2-VASc score in this non-AF population ranges from 0 to 5, whereas in the AF population it typically ranges from 0 to 9 points.
Results: 252 cases of stroke accrued over 15 years. The median and mean ± SD of CHA2DS2-VASc score at baseline were 1.0 and 1.58 ± 1.15, respectively. The cumulative incidence of stroke for the 95th percentile of AI-CAC LA volume (n=291) vs. CHA2DS2-VASc 4 or 5 points (n=364) was 13.0% and 13.7%, respectively. AI-CAC LA volume significantly improved the AUC of CHA2DS2-VASc for stroke prediction at 2-year follow-up (0.76 for CHA2DS2-VASc vs. 0.81 for CHA2DS2-VASc plus LA volume, p=0.03), 5-year follow-up (0.73 vs. 0.77, p=0.01), 10-year follow-up (0.70 vs. 0.75, p<0.0001) and 15- year follow-up (0.70 vs. 0.74, p<0.0001).
Conclusion: In this multi-ethnic longitudinal cohort of people without AF, addition of LA volume significantly improved performance of the CHA2DS2-VASc risk score for stroke prediction from 2 to 15 years follow-up. Further studies are needed to evaluate the clinical utility of adding LA volume to CHA2DS2-VASc risk score in people with and without AF.
  • Naghavi, Morteza  ( HeartLung.AI , Houston , Texas , United States )
  • Reeves, Anthony  ( Cornell University , Ithaca , New York , United States )
  • Atlas, Kyle  ( HeartLung.AI , Houston , Texas , United States )
  • Zhang, Chenyu  ( HeartLung.AI , Houston , Texas , United States )
  • Atlas, Thomas  ( Tustin Teleradiology , Tustin , California , United States )
  • Henschke, Claudia  ( Mount Sinai Hospital , New York , New York , United States )
  • Yankelevitz, David  ( Mount Sinai Hospital , New York , New York , United States )
  • Budoff, Matthew  ( LUNDQUIST INSTITUTE , Torrance , California , United States )
  • Fan, Wenjun  ( University of California Irvine , Irvine , California , United States )
  • Yu, Ruilin  ( UCLA , Los Angeles , California , United States )
  • Branch, Andrea  ( Mount Sinai Hospital , New York , New York , United States )
  • Ma, Ning  ( Mount Sinai Hospital , New York , New York , United States )
  • Roy, Sion  ( UCLA Harbor , Santa Monica , California , United States )
  • Nasir, Khurram  ( Houston Methodist , Houston , Texas , United States )
  • Molloi, Sabee  ( University of California, Irvine , Irvine , California , United States )
  • Fayad, Zahi  ( MOUNT SINAI MEDICAL CENTER , New York , New York , United States )
  • Mcconnell, Michael  ( Stanford University School of Medicine , Stanford , California , United States )
  • Kakadiaris, Ioannis  ( University of Houston , Houston , Texas , United States )
  • Zulueta, Javier  ( Mount Sinai Hospital , New York , New York , United States )
  • Maron, David  ( Stanford University School of Medicine , Stanford , California , United States )
  • Shah, Prediman  ( Cedars-Sinai Medical Center , Los Angeles , California , United States )
  • Williams, Kim  ( University of Louisville Medicine , Louisville , Kentucky , United States )
  • Abela, George  ( Michigan State University , East Lansing , Michigan , United States )
  • Levy, Daniel  ( National Heart, Lung, and Blood Institute , Bethesda , Maryland , United States )
  • Wong, Nathan  ( University of California Irvine , Irvine , California , United States )
    • Author Disclosures:
    Morteza Naghavi: DO have relevant financial relationships ; Ownership Interest:HeartLung.AI:Active (exists now) | Ruilin Yu: DO NOT have relevant financial relationships | Andrea Branch: DO NOT have relevant financial relationships | Ning Ma: No Answer | Sion Roy: DO NOT have relevant financial relationships | Khurram Nasir: No Answer | Sabee Molloi: DO NOT have relevant financial relationships | Zahi Fayad: No Answer | Michael McConnell: DO have relevant financial relationships ; Employee:Toku Inc.:Active (exists now) ; Advisor:Porter Health:Active (exists now) ; Employee:Identifeye Health:Past (completed) | Ioannis Kakadiaris: No Answer | Javier Zulueta: DO have relevant financial relationships ; Advisor:Heart Lung Technologies:Active (exists now) ; Advisor:Disit Biotech:Active (exists now) ; Advisor:OncoSwab:Active (exists now) ; Advisor:Median Technologies:Active (exists now) | Anthony Reeves: No Answer | David Maron: No Answer | Prediman Shah: No Answer | Kim Williams: DO NOT have relevant financial relationships | george Abela: No Answer | Daniel Levy: No Answer | Nathan Wong: No Answer | Kyle Atlas: DO have relevant financial relationships ; Independent Contractor:HeartLung.AI:Active (exists now) | Chenyu Zhang: DO have relevant financial relationships ; Employee:HeartLung Corporation:Active (exists now) ; Individual Stocks/Stock Options:HeartLung Corporation:Active (exists now) | Thomas Atlas: DO NOT have relevant financial relationships | Claudia Henschke: No Answer | David Yankelevitz: DO have relevant financial relationships ; Individual Stocks/Stock Options:HeartLung:Active (exists now) ; Advisor:Lunglife AI:Active (exists now) ; Advisor:Carestream:Active (exists now) ; Advisor:Median Technology:Active (exists now) ; Advisor:HeartLung:Active (exists now) ; Individual Stocks/Stock Options:Accumetra:Active (exists now) ; Royalties/Patent Beneficiary:General Electric:Active (exists now) | Matthew Budoff: DO have relevant financial relationships ; Researcher:General Electric:Active (exists now) | WENJUN FAN: DO NOT have relevant financial relationships
Meeting Info:

Scientific Sessions 2024

2024

Chicago, Illinois

Session Info:

AI at Heart: Revolutionizing Cardiovascular Imaging

Sunday, 11/17/2024 , 11:30AM - 12:30PM

Abstract Poster Session

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