AI-based Identification of Patients Who Benefit from Revascularization: a Multicenter Study
medRxiv the preprint server for health sciences(2025)
Cedars-Sinai Medical Center
Abstract
Background and Aims:Revascularization in stable coronary artery disease often relies on ischemia severity, but we introduce an AI-driven approach that uses clinical and imaging data to estimate individualized treatment effects and guide personalized decisions. Methods:Using a large, international registry from 13 centers, we developed an AI model to estimate individual treatment effects by simulating outcomes under alternative therapeutic strategies. The model was trained on an internal cohort constructed using 1:1 propensity score matching to emulate randomized controlled trials (RCTs), creating balanced patient pairs in which only the treatment strategy-early revascularization (defined as any procedure within 90 days of MPI) versus medical therapy-differed. This design allowed the model to estimate individualized treatment effects, forming the basis for counterfactual reasoning at the patient level. We then derived the AI-REVASC score, which quantifies the potential benefit, for each patient, of early revascularization. The score was validated in the held-out testing cohort using Cox regression. Results:Of 45,252 patients, 19,935 (44.1%) were female, median age 65 (IQR: 57-73). During a median follow-up of 3.6 years (IQR: 2.7-4.9), 4,323 (9.6%) experienced MI or death. The AI model identified a group (n=1,335, 5.9%) that benefits from early revascularization with a propensity-adjusted hazard ratio of 0.50 (95% CI: 0.25-1.00). Patients identified for early revascularization had higher prevalence of hypertension, diabetes, dyslipidemia, and lower LVEF. Conclusions:This study pioneers a scalable, data-driven approach that emulates randomized trials using retrospective data. The AI-REVASC score enables precision revascularization decisions where guidelines and RCTs fall short.
MoreTranslated text
PDF
View via Publisher
AI Read Science
Must-Reading Tree
Example

Generate MRT to find the research sequence of this paper
Data Disclaimer
The page data are from open Internet sources, cooperative publishers and automatic analysis results through AI technology. We do not make any commitments and guarantees for the validity, accuracy, correctness, reliability, completeness and timeliness of the page data. If you have any questions, please contact us by email: report@aminer.cn
Chat Paper
Summary is being generated by the instructions you defined