An artificial intelligence system that can identify people who are likely to have heart attacks up to 10 years in the future could soon be up and running across Britain.
The technology, which can save thousands of lives a year, is being developed by the National Institute for Health and Care Excellence (Nice) and a decision on its use in the NHS is expected by the end of the year.
The project’s scientists also revealed that they are working on similar AI systems to predict whether someone is at risk of having a stroke and to spot those at risk to detect conditions such as diabetes.
“This technology has now been tested at several hospitals across the UK and the results have been hugely encouraging,” said Prof Charalambos Antoniades, leader of the Orfan (Oxford Risk Factors And Non Invasive Imaging) study. “If installed nationally, it will help save thousands of people from early heart attacks or deaths from heart disease.”
More than 300,000 people in Britain suffered severe chest pains each year and were given CT scans to determine if they were suffering from heart disorders such as arterial blockages, Antoniades said. However, less than 20% of those scanned had obstructions or dangerous narrowing of their coronary arteries. “The remaining 80%-plus show no abnormalities. They are reassured and sent home, very often without any medication,” said Antoniades, chairman of cardiovascular medicine at the University of Oxford. “However, these reassurances are often misplaced.”
In fact, about two-thirds of this “safe” group suffer major — sometimes fatal — heart attacks, including heart attacks. “Clearly we missed signals from our scans that could tell us about those who are in real danger,” he added. “This is a massive healthcare problem, and we believe AI is the perfect technology to deal with it.”
The researchled by a team at Oxford University’s Radcliffe Department of Medicine and published in the Lancet last week, is designed to detect the abnormalities missed by standard CT (computed tomography) scans. This knowledge will enable doctors to give the patients preventive treatments such as anti-inflammatory drugs.
Much of the problem was that damage to an artery caused by inflammation was not picked up by a CT scan, Antoniades said. “Our discovery was to find a way to bring out hidden information by using AI to enhance our CT scan images to show what damage has been done. In the past we couldn’t imagine it, but now we can.”
The technique uses data on the characteristics of coronary plaques, as well as changes in the fat around inflamed arteries, to provide key information about the health status of our heart arteries. “Essentially, these readings tell us what the absolute risk is that a patient will have a fatal cardiac event over the next 10 years,” he said.
These risk factors were originally worked out using US case studies, but the data have since been evaluated using 40,000 patients at UK hospitals.
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“What we found was clear. Patients who showed high inflammation in their coronary arteries were also found to have an extremely high risk of suffering serious heart disease, such as heart attacks. We have found a way to identify the hidden factors that lead to heart attacks.
The study, funded by the British Heart Foundation, revealed that in 45% of cases, clinicians decided to change a patient’s treatment in light of data provided by AI analysis. These treatments include giving high doses of statins or drugs such as colchicine, which are known to reduce risks of cardiovascular disease.
Antoniades added: “We also plan to expand the delivery of this UK-made technology in the US, where it is also being evaluated by the Food and Drug Administration, and in Europe where it has already been approved for clinical use.”
