Deep convolutional neural networks to predict cardiovascular risk from computed tomography

Roman Zeleznik, Borek Foldyna, Parastou Eslami, Jakob Weiss, Ivanov Alexander, Jana Taron, Chintan Parmar, Raza M. Alvi, Dahlia Banerji, Mio Uno, Yasuka Kikuchi, Julia Karady, Lili Zhang, Jan Erik Scholtz, Thomas Mayrhofer, Asya Lyass, Taylor F. Mahoney, Joseph M. Massaro, Ramachandran S. Vasan, Pamela S. DouglasUdo Hoffmann, Michael T. Lu, Hugo J.W.L. Aerts

Research output: Contribution to journalArticlepeer-review

114 Scopus citations


Coronary artery calcium is an accurate predictor of cardiovascular events. While it is visible on all computed tomography (CT) scans of the chest, this information is not routinely quantified as it requires expertise, time, and specialized equipment. Here, we show a robust and time-efficient deep learning system to automatically quantify coronary calcium on routine cardiac-gated and non-gated CT. As we evaluate in 20,084 individuals from distinct asymptomatic (Framingham Heart Study, NLST) and stable and acute chest pain (PROMISE, ROMICAT-II) cohorts, the automated score is a strong predictor of cardiovascular events, independent of risk factors (multivariable-adjusted hazard ratios up to 4.3), shows high correlation with manual quantification, and robust test-retest reliability. Our results demonstrate the clinical value of a deep learning system for the automated prediction of cardiovascular events. Implementation into clinical practice would address the unmet need of automating proven imaging biomarkers to guide management and improve population health.

Original languageEnglish (US)
Article number715
JournalNature communications
Issue number1
StatePublished - Dec 1 2021
Externally publishedYes

ASJC Scopus subject areas

  • General Chemistry
  • General Biochemistry, Genetics and Molecular Biology
  • General Physics and Astronomy


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