Evidence map›Paper›PMID 41624556›Full record

ArticleEuropean heart journal. Digital health2026

Multimodal deep learning for acute myocardial infarction detection from 12-lead electrocardiogram: a multi-centre study with cross-hospital validation.

Vibha Gupta, Lukas Hilgendorf, Erik Andersson, Antros Louca, Arman Shahmari, Alfred Hjalmarsson, Rajkumar Saini, Carlo Pirazzi, Monér Alchay, Araz Rawshani

Abstract read
In one paragraph

Article in European heart journal. Digital health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing 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

1 citing paper in PubMed.

  1. 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

10 authors.

Vibha GuptaDepartment of Molecular and Clinical Medicine, Institute of Medicine, University of Gothenburg, Bruna Stråket 16, 413 45 Göteborg, Gothenburg, Sweden.ORCID https://orcid.org/0000-0002-3785-8380
Lukas HilgendorfDepartment of Molecular and Clinical Medicine, Institute of Medicine, University of Gothenburg, Bruna Stråket 16, 413 45 Göteborg, Gothenburg, Sweden.ORCID https://orcid.org/0009-0000-9518-3644
Erik AnderssonDepartment of Molecular and Clinical Medicine, Institute of Medicine, University of Gothenburg, Bruna Stråket 16, 413 45 Göteborg, Gothenburg, Sweden.
Antros LoucaDepartment of Molecular and Clinical Medicine, Institute of Medicine, University of Gothenburg, Bruna Stråket 16, 413 45 Göteborg, Gothenburg, Sweden.
Arman ShahmariDepartment of Molecular and Clinical Medicine, Institute of Medicine, University of Gothenburg, Bruna Stråket 16, 413 45 Göteborg, Gothenburg, Sweden.
Alfred HjalmarssonDepartment of Molecular and Clinical Medicine, Institute of Medicine, University of Gothenburg, Bruna Stråket 16, 413 45 Göteborg, Gothenburg, Sweden.
Rajkumar SainiDepartment of Computer Science, Electrical and Space Engineering, Luleå University of Technology, Luleå SE-971 87, Sweden.
Carlo PirazziDepartment of Thoracic Surgery and Cardiology, Sahlgrenska University Hospital, Blå Stråket 5, Gothenburg, Västra Götaland SE-413 45, Sweden.
Monér AlchayDepartment of Molecular and Clinical Medicine, Institute of Medicine, University of Gothenburg, Bruna Stråket 16, 413 45 Göteborg, Gothenburg, Sweden.
Araz RawshaniDepartment of Molecular and Clinical Medicine, Institute of Medicine, University of Gothenburg, Bruna Stråket 16, 413 45 Göteborg, Gothenburg, Sweden.ORCID https://orcid.org/0000-0003-2066-3533

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Aims: Acute myocardial infarction (AMI) remains a leading global cause of mortality, where timely diagnosis is critical to enable early intervention. The 12-lead electrocardiogram (ECG) is a critical tool for AMI detection. While deep learning (DL) models show promise for automated ECG analysis, most prior studies rely on small, curated datasets with limited external validation, limiting their clinical applicability. Methods and results: We developed a multimodal DL model (Conv-BiLSTM-Attn) integrating convolutional and recurrent neural networks with an attention mechanism. Using a large, multi-centre dataset of 145 656 ECGs from 96 813 patients across three Swedish hospitals. We trained the model to detect AMI using raw 12-lead ECG signals and demographic inputs (age, sex). Model performance was evaluated under two external validation protocols: generalization across hospitals (GAH) and leave-one-hospital-out (LOHO). The model achieved an area under the receiver operating characteristic (AUROC) of 0.848 (95% CI: 0.84-0.86) and an area under the precision-recall (AUPRC) of 0.456, reflecting class imbalance (∼6-10% AMI prevalence) under the GAH protocol. Subgroup AUROCs ranged from 0.79 to 0.92 across age and sex groups. At the Youden-optimized threshold (0.439), the model showed sensitivity of 0.736, specificity of 0.793, negative predictive value of 0.976, and weighted F1-score of 0.837. Under the LOHO protocol, AUROCs ranged from 0.801-0.849. At Youden thresholds (0.34-0.50), sensitivity ranged from 0.671 to 0.776 and specificity from 0.651 to 0.801, confirming generalizability across sites. Conv-BiLSTM-Attn outperformed benchmark models, with Score-CAM highlighting relevant ST-T segments. Conclusion: This DL model can support accurate and generalizable AMI detection from routine ECGs, with the Conv-BiLSTM-Attn architecture outperforming current benchmark approaches.

Indexed as

Acute myocardial infarction (AMI)Artificial intelligence in cardiologyDeep learningElectrocardiogram (ECG)External validationMultimodal neural network

Identifiers

PMID41624556
PMCPMC12853118

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

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.