Evidence map›Paper›PMID 40847485›Full record

ArticleJournal of the American Heart Association2025

Using Machine Learning to Risk Stratify Emergency Department Patients With Chest Pain but No Acute Myocardial Infarction: A Multicenter Retrospective Analysis.

Eric H Chou, Tsung-Chien Lu, Yong-Tai Chiu, Fan-Ya Chou, Jeffrey Hamada, Jaydeep Shah, Sandeep Shori, Matthew Danley, Andrew Shedd, Toral Bhakta and 3 more

Abstract readMulticenter Study
In one paragraph

Article in Journal of the American Heart Association, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors.

Eric H ChouDepartment of Emergency Medicine Baylor Scott and White All Saints Medical Center Fort Worth TX USA.ORCID 0000-0002-6731-6304
Tsung-Chien LuDepartment of Emergency Medicine, College of Medicine National Taiwan University Taipei Taiwan.ORCID 0000-0003-2729-7142
Yong-Tai ChiuGraduate Institute of Electrical Engineering National Taiwan University Taipei Taiwan.
Fan-Ya ChouDepartment of Emergency Medicine National Taiwan University Hospital Taipei Taiwan.ORCID 0000-0003-1149-423X
Jeffrey HamadaDepartment of Emergency Medicine Baylor Scott and White All Saints Medical Center Fort Worth TX USA.
Jaydeep ShahDepartment of Anesthesiology Baylor Scott and White All Saints Medical Center Fort Worth TX USA.ORCID 0009-0003-2900-3459
Sandeep ShoriDepartment of Internal Medicine Baylor Scott and White All Saints Medical Center Fort Worth TX USA.
Matthew DanleyDepartment of Anesthesiology Baylor Scott and White All Saints Medical Center Fort Worth TX USA.ORCID 0000-0003-1415-6746
Andrew SheddDepartment of Emergency Medicine Baylor Scott and White All Saints Medical Center Fort Worth TX USA.ORCID 0000-0003-4000-0374
Toral BhaktaDepartment of Emergency Medicine Baylor Scott and White All Saints Medical Center Fort Worth TX USA.
Chu-Lin TsaiDepartment of Emergency Medicine, College of Medicine National Taiwan University Taipei Taiwan.ORCID 0000-0003-4639-1513
Chih-Hung WangDepartment of Emergency Medicine, College of Medicine National Taiwan University Taipei Taiwan.ORCID 0000-0003-0802-7825
Hung-Yu WeiDepartment of Electrical Engineering and Graduate Institute of Communications Engineering National Taiwan University Taipei Taiwan.ORCID 0000-0002-3116-306X

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThis study aimed to develop a machine learning-based model to predict the risk of major adverse cardiac events (MACE) in patients presenting to the emergency department (ED) with chest pain, for whom acute myocardial infarction was excluded after serial high-sensitivity cardiac troponin testing.

methodsThis retrospective analysis included adult patients presenting with chest pain at 5 study hospitals between 2021 and 2024 in Texas. Patients diagnosed with acute myocardial infarction during the index visit were excluded. The primary outcome was the occurrence of 30-day MACE, defined as myocardial infarction or all-cause mortality within 30 days of the index ED visit. A long short-term memory algorithm was used to develop the prediction model.

resultsThe analysis included 14 177 patients with a median age of 49.7 years, 41.2% of whom were men. A total of 535 patients (3.8%) had at least 1 high-sensitivity cardiac troponin level above the 99th percentile. Thirty-nine patients (0.3%) experienced 30-day MACE, including 15 (0.1%) with myocardial infarction and 24 (0.2%) with all-cause mortality. The long short-term memory model demonstrated excellent performance in predicting 30-day MACE (area under the receiver operating characteristic curve [AUC], 0.884 [95% CI, 0.815-0.941]), myocardial infarction (AUC, 0.963 [95% CI, 0.926-0.993]), and all-cause mortality (AUC, 0.849 [95% CI, 0.698-0.948]).

conclusionsThe long short-term memory model accurately predicted 30-day MACE in ED patients presenting with chest pain and no acute myocardial infarction, using patient demographics, vital signs at ED presentation, electrocardiographic findings, and serial high-sensitivity cardiac troponin levels measured at flexible time points within 24 hours of ED arrival.

Indexed as

Chest PainEmergency Service, HospitalMachine LearningMyocardial InfarctionAdultAgedBiomarkersFemaleHumansMaleMiddle AgedPredictive Value of TestsRetrospective StudiesRisk AssessmentRisk FactorsTexasBiomarkersTroponinacute coronary syndromechest paindeep learningemergency departmentmachine learningmajor adverse cardiac eventsmyocardial infarction

Identifiers

PMID40847485
PMCPMC12553410

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.