Technology developed using artificial intelligence (AI) can identify people at high risk of a fatal heart attack at least five years before it strikes, researchers have said.
Researchers at the University of Oxford have developed a new biomarker called the fat radiomic profile (FRP), which detects biological red flags in the space lining blood vessels which supply blood to the heart.
It identifies inflammation, scarring and changes to these blood vessels, which are all pointers to a future heart attack.
When someone goes to hospital with chest pain, a standard component of care is to have a coronary CT angiogram (CCTA), which checks for any narrowed or blocked segments. If there is no significant narrowing of the artery, which accounts for about 75% of scans, people are sent home but some of them will still have a heart attack at some point in the future.
There are no methods used routinely by doctors that can spot all of the underlying red flags for a future heart attack.
In the study, Professor Charalambos Antoniades and his team used fat biopsies from 167 people undergoing cardiac surgery. They analysed the expression of genes associated with inflammation, scarring and new blood vessel formation, and matched these to the CCTA scan images to determine which features best indicate changes to the fat surrounding the heart vessels, called perivascular fat.
The team then compared the CCTA scans of the 101 people, from a pool of 5,487 individuals, who went on to have a heart attack or cardiovascular death within five years of having a CCTA, with matched controls who did not. This enables them to understand the changes in the perivascular space which indicate that someone is at higher risk of a heart attack.
Using machine learning, they developed the FRP fingerprint that captures the level of risk. The more heart scans that are added, the more accurate the predictions will become.
The team plans to roll out the technology to healthcare professionals in the next year, with the hope that it will be included in routine NHS practice alongside CCTA scans in the next two years.
Antoniades said that just because someone’s scan of their
coronary artery shows there is no narrowing, that does not mean they are safe
from a heart attack.
“By harnessing the power of AI, we’ve developed a fingerprint to find ‘bad’ characteristics around people’s arteries. This has huge potential to detect the early signs of disease, and to be able to take all preventative steps before a heart attack strikes, ultimately saving lives,” he added. The study was presented at the European Society of Cardiology (ESC) Congress in Paris and published in the European Heart Journal.