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Thus, this study developed and validated several ECG-based models for cardiovascular disease (CVD) risk assessment, with or without simple questionnaire-based variables.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods and results<\/jats:title>\n                  <jats:p>Using a derivation cohort of 3734 Chinese participants aged \u226540 years, we developed the ECG-based models to predict the risk of developing CVD (comprising fatal and non-fatal coronary heart disease, unstable angina, stroke, and heart failure). Candidate predictors associated with CVD were screened from hundreds of ECG characteristics using a hybrid algorithm. By incorporating the questionnaire-based predictors, we constructed the ECG\u2013questionnaire model. All models were tested in an external validation cohort (n = 1224) to determine their discrimination and calibration. Over a maximum follow-up of 7 years, 433 CVD events occurred in the derivation cohort. The ECG model with 37 selected features achieved comparable performance concerning the clinical model using traditional cardiovascular risk factors (C-statistic: 0.690, 95% confidence interval [CI]: 0.638\u20130.743) in the external validation cohort. Such performance significantly improved when the questionnaire-based predictors were added (C-statistic: 0.734, 95% CI: 0.685\u20130.784; calibration \u03c72: 3.334, P = 0.950). Compared with the clinical model, 17.4% of the participants were correctly assigned to the corresponding risk groups, with an absolute integrated discrimination index of 0.048 (95% CI: 0.016\u20130.080).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>The ECG model with\/without questionnaire-based variables can accurately predict future CVD risk independent of physical and laboratory examinations, suggesting its great potential in routine clinical practice.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ehjdh\/ztaf023","type":"journal-article","created":{"date-parts":[[2025,3,19]],"date-time":"2025-03-19T08:25:46Z","timestamp":1742372746000},"page":"466-475","source":"Crossref","is-referenced-by-count":2,"title":["A hybrid algorithm-based ECG risk prediction model for cardiovascular 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and Blood Vessel Diseases , Beijing ,","place":["China"]},{"name":"National Clinical Research Center for Cardiovascular Diseases , Beijing ,","place":["China"]},{"name":"The Key Laboratory of Remodeling-Related Cardiovascular Diseases, Ministry of Education , Beijing ,","place":["China"]},{"name":"The Beijing Municipal Key Laboratory of Clinical Epidemiology , Beijing ,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yiming","family":"Hao","sequence":"additional","affiliation":[{"name":"Center for Clinical and Epidemiologic Research, Beijing Anzhen Hospital, Capital Medical University , Beijing ,","place":["China"]},{"name":"Beijing Institute of Heart, Lung and Blood Vessel Diseases , Beijing ,","place":["China"]},{"name":"National Clinical Research Center for Cardiovascular Diseases , Beijing ,","place":["China"]},{"name":"The Key Laboratory of Remodeling-Related Cardiovascular Diseases, Ministry of Education , Beijing ,","place":["China"]},{"name":"The Beijing Municipal Key Laboratory of Clinical Epidemiology , Beijing ,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fangfang","family":"Fan","sequence":"additional","affiliation":[{"name":"Institute of Cardiovascular Disease, Peking University First Hospital , No.8 Xishiku Road, Xicheng District, Beijing 100034 ,","place":["China"]},{"name":"Department of Cardiology, Peking University First Hospital , No.8 Xishiku Road, Xicheng District, Beijing 100034 ,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wenlang","family":"Zhao","sequence":"additional","affiliation":[{"name":"Center for Clinical and Epidemiologic Research, Beijing Anzhen Hospital, Capital Medical University , Beijing ,","place":["China"]},{"name":"Beijing Institute of Heart, Lung and Blood Vessel Diseases , Beijing ,","place":["China"]},{"name":"National Clinical Research Center for Cardiovascular Diseases , Beijing ,","place":["China"]},{"name":"The Key Laboratory of Remodeling-Related Cardiovascular Diseases, Ministry of Education , Beijing ,","place":["China"]},{"name":"The Beijing Municipal Key Laboratory of Clinical Epidemiology , Beijing ,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ziyu","family":"Wang","sequence":"additional","affiliation":[{"name":"Center for Clinical and Epidemiologic Research, Beijing Anzhen Hospital, Capital Medical University , Beijing ,","place":["China"]},{"name":"Beijing Institute of Heart, Lung and Blood Vessel Diseases , Beijing ,","place":["China"]},{"name":"National Clinical Research Center for Cardiovascular Diseases , Beijing ,","place":["China"]},{"name":"The Key Laboratory of Remodeling-Related Cardiovascular Diseases, Ministry of Education , Beijing ,","place":["China"]},{"name":"The Beijing Municipal Key Laboratory of Clinical Epidemiology , Beijing ,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qiuju","family":"Deng","sequence":"additional","affiliation":[{"name":"Center for Clinical and Epidemiologic Research, Beijing Anzhen Hospital, Capital Medical University , Beijing ,","place":["China"]},{"name":"Beijing Institute of Heart, Lung and Blood Vessel Diseases , Beijing ,","place":["China"]},{"name":"National Clinical Research Center for Cardiovascular Diseases , Beijing ,","place":["China"]},{"name":"The Key Laboratory of Remodeling-Related Cardiovascular Diseases, Ministry of Education , Beijing ,","place":["China"]},{"name":"The Beijing Municipal Key Laboratory of Clinical Epidemiology , Beijing ,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yongchen","family":"Hao","sequence":"additional","affiliation":[{"name":"Center for Clinical and Epidemiologic Research, Beijing Anzhen Hospital, Capital Medical University , Beijing ,","place":["China"]},{"name":"Beijing Institute of Heart, Lung and Blood Vessel Diseases , Beijing ,","place":["China"]},{"name":"National Clinical Research Center for Cardiovascular Diseases , Beijing ,","place":["China"]},{"name":"The Key Laboratory of Remodeling-Related Cardiovascular Diseases, Ministry of Education , Beijing ,","place":["China"]},{"name":"The Beijing Municipal Key Laboratory of Clinical Epidemiology , Beijing ,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9022-171X","authenticated-orcid":false,"given":"Na","family":"Yang","sequence":"additional","affiliation":[{"name":"Center for Clinical and Epidemiologic Research, Beijing Anzhen Hospital, Capital Medical University , Beijing ,","place":["China"]},{"name":"Beijing Institute of Heart, Lung and Blood Vessel Diseases , Beijing ,","place":["China"]},{"name":"National Clinical Research Center for Cardiovascular Diseases , Beijing ,","place":["China"]},{"name":"The Key Laboratory of Remodeling-Related Cardiovascular Diseases, Ministry of Education , Beijing ,","place":["China"]},{"name":"The Beijing Municipal Key Laboratory of Clinical Epidemiology , Beijing ,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lizhen","family":"Han","sequence":"additional","affiliation":[{"name":"Center for Clinical and Epidemiologic Research, Beijing Anzhen Hospital, Capital Medical University , Beijing ,","place":["China"]},{"name":"Beijing Institute of Heart, Lung and Blood Vessel Diseases , Beijing ,","place":["China"]},{"name":"National Clinical Research Center for Cardiovascular Diseases , Beijing ,","place":["China"]},{"name":"The Key Laboratory of Remodeling-Related Cardiovascular Diseases, Ministry of Education , Beijing ,","place":["China"]},{"name":"The Beijing Municipal Key Laboratory of Clinical Epidemiology , Beijing ,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pingping","family":"Jia","sequence":"additional","affiliation":[{"name":"Center for Clinical and Epidemiologic Research, Beijing Anzhen Hospital, Capital Medical University , Beijing ,","place":["China"]},{"name":"Beijing Institute of Heart, Lung and Blood Vessel Diseases , Beijing ,","place":["China"]},{"name":"National Clinical Research Center for Cardiovascular Diseases , Beijing ,","place":["China"]},{"name":"The Key Laboratory of Remodeling-Related Cardiovascular Diseases, Ministry of Education , Beijing ,","place":["China"]},{"name":"The Beijing Municipal Key Laboratory of Clinical Epidemiology , Beijing ,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yue","family":"Qi","sequence":"additional","affiliation":[{"name":"Center for Clinical and Epidemiologic Research, Beijing Anzhen Hospital, Capital Medical University , Beijing 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