AI-enabled CCTA evaluations reduce use of invasive imaging exams
Evaluating the cardiac CT results of patients with chest pain using artificial intelligence (AI) is safe, effective and can significantly reduce the need for downstream imaging exams, according to new data published in Nature Medicine.[1]
Researchers reviewed two-year data from FISH&CHIPS, a clinical trial conducted by the National Health Service (NHS) at 27 hospitals in England. The study included more than 90,000 patients who underwent coronary CT angiography (CCTA) after presenting with chest pain. The mean age was 58 years old, 48.1% of patients were female and the median follow-up period was 3.3 years.
FISH&CHIPS examined the potential value of evaluating CCTA results with FFRCT Analysis, an AI-powered CT-derived fractional flow reserve (FFRCT) technology developed by Heartflow. FFRCT Analysis was used to examine the CCTA results of 14.1% of chest pain patients. They were selected to undergo additional analysis after clinicians identified warning signs of coronary artery disease.
Overall, patients evaluated with FFRCT were associated with significant decreases in the use of downstream tests. The use of invasive coronary angiograms (ICAs) was reduced by 7% and the use of unneeded ICAs that did not result in treatment was reduced by 16%. There was no difference in all-cause mortality after two years.
Another key takeaway from the group’s findings was that FFRCT Analysis helped identify more patients who required percutaneous coronary intervention (PCI). Overall, approximately one extra appropriate PCI patient was detected for every two unnecessary diagnostic catheterizations.
“New findings from the FISH&CHIPS study demonstrate that a CCTA+FFRCT pathway at a national level can positively impact individual patient care, improving the suspected coronary artery disease patient’s journey,” principal investigator Timothy Fairbairn, MBChB, PhD, a cardiologist with Liverpool Heart and Chest Hospital NHS Foundation Trust and an associate professor at the University of Liverpool, said in a statement. “FFRCT is a major AI-driven advancement in the management of cardiac disease that is helping to ensure that patients receive more precise, improved care, by reducing unnecessary invasive procedures and additional tests whilst identifying those who need intervention.”
“By implementing a nationwide CCTA-first strategy for assessing patients with potential cardiovascular disease, NHS has set the standard for both clinical efficacy and efficiency — an approach now reflected in clinical guidelines worldwide,” added Campbell Rogers, MD, Heartflow’s chief medical officer. “The FISH&CHIPS data underscore how the addition of Heartflow’s FFRCT technology can improve upon the CCTA-first approach for many patients and optimize the use of both noninvasive testing and treatment.”
While the study’s authors did not receive funding from Heartflow to perform this study, two co-authors were Heartflow employees.
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Michael has more than 18 years of experience as a professional writer and editor. He has written at length about cardiology, radiology, artificial intelligence and other key healthcare topics.