Background: Clinical endpoint classification (CEC) is the gold standard for cardiovascular endpoint measurement in clinical trials, but adds time and cost. We developed and validated an artificial intelligence (AI) algorithm (ADAPT-CEC) that adjudicates multiple cardiovascular endpoints and adapts to new definitions. Methods: ADAPT-CEC was derived on myocardial infarction (MI), stroke, and heart failure from the ODYSSEY OUTCOMES trial and externally validated on MI, stroke, bleeding and CV death