Noninvasive Voice Biomarker Is Associated With Incident Coronary Artery Disease Events at Follow-up

Jaskanwal Deep Singh Sara, Elad Maor, Diana Orbelo, Rajiv Gulati, Lliach O. Lerman, Amir Lerman

Research output: Contribution to journalArticlepeer-review


Objective: To evaluate the association between a preidentified voice biomarker and incident coronary artery disease (CAD) events. Methods: Patients referred for clinically indicated coronary angiography underwent a total of three 30-second voice recordings using the Vocalis Health smartphone application between January 1, 2015, and February 28, 2017. A pre-established voice biomarker was derived from each individual recording, and the mean biomarker value was calculated for each patient. Individuals were clinically observed through December 31, 2019. The prespecified primary outcome was a composite of presenting to the emergency department with chest pain, being admitted to the hospital with chest pain, or having an acute coronary syndrome; the prespecified secondary outcome was a composite of a positive stress test result at follow-up or the presence of CAD at follow-up coronary angiography. Results: In the final analysis, 108 patients were included (mean age, 59.47±11.44 years; male, 59 [54.6%]). The median follow-up time was 24 months (range, 1 to 60 months). In multivariable Cox proportional hazards models adjusting for CAD grade on baseline angiography, a high baseline mean voice biomarker was significantly associated with both the primary (hazard ratio, 2.61; 95% CI, 1.42 to 4.80; P=.002) and secondary (hazard ratio, 3.13; 95% CI, 1.13 to 8.68; P=.03) composite outcomes. Conclusion: This study found a significant association between a noninvasive voice biomarker and incident CAD events at follow-up. These results may have important clinical implications for the remote and noninvasive screening of patients to identify those at risk of coronary disease and its complications.

Original languageEnglish (US)
Pages (from-to)835-846
Number of pages12
JournalMayo Clinic proceedings
Issue number5
StatePublished - May 2022

ASJC Scopus subject areas

  • General Medicine


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