Background: The use of an artificial intelligence electrocardiography (AI-ECG) algorithm has demonstrated its reliability in predicting the risk of atrial fibrillation (AF) within the general population.
Objectives: This study aimed to determine the effectiveness of the AI-ECG score in identifying patients with chronic lymphocytic leukemia (CLL) who are at high risk of developing AF.
Methods: We estimated the probability of AF based on AI-ECG among patients with CLL extracted from the Mayo Clinic CLL database. Additionally, we computed the Mayo Clinic CLL AF risk score and determined its ability to predict AF.
Results: Among 754 newly diagnosed patients with CLL, 71.4% were male (median age = 69 years). The median baseline AI-ECG score was 0.02 (range = 0-0.93), with a value ≥0.1 indicating high risk. Over a median follow-up of 5.8 years, the estimated 10-year cumulative risk of AF was 26.1%. Patients with an AI-ECG score of ≥0.1 had a significantly higher risk of AF (HR: 3.9; 95% CI: 2.6-5.7; P < 0.001). This heightened risk remained significant (HR: 2.5; 95% CI: 1.6-3.9; P < 0.001) even after adjusting for the Mayo CLL AF risk score, heart failure, chronic kidney disease, and CLL therapy. In a second cohort of CLL patients treated with a Bruton tyrosine kinase inhibitor (n = 220), a pretreatment AI-ECG score ≥0.1 showed a nonsignificant increase in the risk of AF (HR: 1.7; 95% CI: 0.8-3.6; P = 0.19).
Conclusions: An AI-ECG algorithm, in conjunction with the Mayo CLL AF risk score, can predict the risk of AF in patients with newly diagnosed CLL. Additional studies are needed to determine the role of AI-ECG in predicting AF risk in CLL patients treated with a Bruton tyrosine kinase inhibitor.
Competing Interests: Dr Herrmann was supported National Institutes of Health/NCI (RO1 CA233610), Miami Heart Research Institute, and Mayo Clinic Department of Cardiovascular Medicine. This research was supported in part by the Henry J. Predolin Foundation. IP related to AI-ECG algorithm for AF risk has been licensed to Anumana (potential equity/royalty relationship). Dr Ding has received research funding from Merck and DTRM; and has served on the Advisory Boards of Merck and Octapharma (no personal compensation). Dr Kenderian is an inventor on patents in the field of CAR immunotherapy that are licensed to Novartis (through an agreement between Mayo Clinic, University of Pennsylvania, and Novartis), Humanigen (through Mayo Clinic), Morphosys (through Mayo Clinic), Tolero (through Mayo Clinic), and Mettaforge (through Mayo Clinic); has received research funding from Kite, Gilead, Juno, Celgene, Novartis, Humanigen, MorphoSys, Tolero, Sunesis, Leahlabs; and Lentigen; has participated in consultancy with Torque, Leahlabs, and Kiniksa; has participated in scientific advisory board meetings of Juno, Kite, and Humanigen; and has participated in data safety monitoring board meetings of Humanigen. Dr Wang has received research funding (to the institution) from Incyte, InnoCare, Novartis, LOXO Oncology, Eli Lilly, MorphoSys, Novartis, Genentech, and Genmab; has served on the Advisory Boards (compensation to institution) of Eli Lilly, LOXO Oncology, TG Therapeutics, Incyte, InnoCare, Kite, Jansen, BeiGene; has served as a consultant (compensation to institution) to Innocare and AbbVie; and has received honorarium (to institution) from Kite. Dr Kay has served on the Advisory Boards for AbbVie, AstraZeneca, BeiGene, Behring, Boehringer Ingelheim Pharmaceuticals Inc, Dava Oncology, Janssen, Juno Therapeutics, and Pharmacyclics; has served on the Data Safety Monitoring Committee for Agios Pharm, AstraZeneca, Bristol-Myers Squibb Celgene, and Dren Bio Janssen; and has received research funding from: AbbVie, Acerta Pharma, Bristol Meyer Squib, Celgene, Genentech, Pharmacyclics, Sunesis, and Vincerx. Dr Kappor has served as a consultant for Sanofi and Cellectar; has received research funding from Sanofi, Janssen, Amgen, GlaxoSmithKline, Takeda, and AbbVie; and has received honoraria from Celgene, Janssen, Takeda, Karyopharm, Beigene, and AbbVie. Dr Shanafelt has received research support to his institution from Genentech, AbbVie, and Pharmacyclics. Dr Herrmann has served on the Advisory Board for AstraZenca, Astellas, and Pfizer; and has received royalties from Elsevier, Inc. Dr Parikh has received research funding to his institution from Janssen, AstraZeneca, Merck, and Genentech for clinical studies in which Dr Parikh is a principal investigator; and has received honoraria to his institution from Pharmacyclics, Merck, AstraZeneca, Janssen, BeiGene, Genentech, Amgen, MingSight Pharmaceuticals, TG Therapeutics, NovalGen Limited, Kite Pharma, and AbbVie for his participation in consulting activities/advisory board meetings. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose. This research was previously presented as an abstract at the American Society of Hematology Scientific Sessions in 2020, December 7, 2020, virtual poster session.
(© 2024 The Authors.)