{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T04:30:49Z","timestamp":1792211449995,"version":"4.4.0"},"reference-count":36,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2024,2,6]]},"abstract":"<jats:sec sec-type=\"background\" xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">Patients with peripheral artery disease are at increased risk for major adverse cardiac events, major adverse limb events, and all\u2010cause death. Developing tools capable of identifying those patients with peripheral artery disease at greatest risk for major adverse events is the first step for outcome prevention. This study aimed to determine whether computer\u2010assisted analysis of a resting Doppler waveform using deep neural networks can accurately identify patients with peripheral artery disease at greatest risk for adverse outcome events.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Methods and Results<\/jats:title>\n                    <jats:p xml:lang=\"en\">Consecutive patients (April 1, 2015, to December 31, 2020) undergoing ankle\u2013brachial index testing were included. Patients were randomly allocated to training, validation, and testing subsets (60%\/20%\/20%). Deep neural networks were trained on resting posterior tibial arterial Doppler waveforms to predict major adverse cardiac events, major adverse limb events, and all\u2010cause death at 5\u2009years. Patients were then analyzed in groups based on the quartiles of each prediction score in the training set. Among 11\u2009384 total patients, 10\u2009437 patients met study inclusion criteria (mean age, 65.8\u00b114.8\u2009years; 40.6% women). The test subset included 2084 patients. During 5\u2009years of follow\u2010up, there were 447 deaths, 585 major adverse cardiac events, and 161 MALE events. After adjusting for age, sex, and Charlson comorbidity index, deep neural network analysis of the posterior tibial artery waveform provided independent prediction of death (hazard ratio [HR], 2.44 [95% CI, 1.78\u20133.34]), major adverse cardiac events (HR, 1.97 [95% CI, 1.49\u20132.61]), and major adverse limb events (HR, 11.03 [95% CI, 5.43\u201322.39]) at 5\u2009years.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">An artificial intelligence\u2013enabled analysis of Doppler arterial waveforms enables identification of major adverse outcomes among patients with peripheral artery disease, which may promote early adoption and adherence of risk factor modification.<\/jats:p>\n                  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