Cost-effectiveness of a novel AI technology to quantify coronary inflammation and cardiovascular risk in patients undergoing routine coronary computed tomography angiography.

Journal: European heart journal. Quality of care & clinical outcomes
Published Date: Jun 23, 2025

Abstract

AIMS: Coronary computed tomography angiography (CCTA) is a first-line investigation for chest pain in patients with suspected obstructive coronary artery disease (CAD). However, many acute cardiac events occur in the absence of obstructive CAD. We assessed the lifetime cost-effectiveness of integrating a novel artificial intelligence-enhanced image analysis algorithm (AI-Risk) that stratifies the risk of cardiac events by quantifying coronary inflammation, combined with the extent of coronary artery plaque and clinical risk factors, by analysing images from routine CCTA.

Authors

  • Apostolos Tsiachristas
    Nuffield Department of Primary Care Health Sciences & Department of Psychiatry, University of Oxford, Oxford, OX2 6GG, UK.
  • Kenneth Chan
    Acute Multidisciplinary Imaging & Interventional Centre, British Heart Foundation (BHF) Centre of Research Excellence, Division of Cardiovascular Medicine, Radcliffe Department of Medicine, Oxford NIHR Biomedical Research Centre, University of Oxford, John Radcliffe Hospital, Headley Way, Oxford, OX3 9DU, UK.
  • Elizabeth Wahome
    Acute Multidisciplinary Imaging & Interventional Centre, British Heart Foundation (BHF) Centre of Research Excellence, Division of Cardiovascular Medicine, Radcliffe Department of Medicine, Oxford NIHR Biomedical Research Centre, University of Oxford, John Radcliffe Hospital, Headley Way, Oxford, OX3 9DU, UK.
  • Ben Kearns
    Lumanity, Sheffield, S1 2GQ, UK.
  • Parijat Patel
    Acute Multidisciplinary Imaging & Interventional Centre, Division of Cardiovascular Medicine, Radcliffe Department of Medicine, John Radcliffe Hospital, Level 6 West Wing, Headley Way, Oxford OX37TH, UK.
  • Maria Lyasheva
    Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, John Radcliffe Hospital, Headley Way, Oxford, UK.
  • Nigar Syed
    Caristo Diagnostics, Oxford, OX2 0HP, UK.
  • Sam Fry
    Caristo Diagnostics, Oxford, OX2 0HP, UK.
  • Thomas Halborg
    Acute Multidisciplinary Imaging & Interventional Centre, British Heart Foundation (BHF) Centre of Research Excellence, Division of Cardiovascular Medicine, Radcliffe Department of Medicine, Oxford NIHR Biomedical Research Centre, University of Oxford, John Radcliffe Hospital, Headley Way, Oxford, OX3 9DU, UK.
  • Henry West
    Acute Multidisciplinary Imaging & Interventional Centre, British Heart Foundation (BHF) Centre of Research Excellence, Division of Cardiovascular Medicine, Radcliffe Department of Medicine, Oxford NIHR Biomedical Research Centre, University of Oxford, John Radcliffe Hospital, Headley Way, Oxford, OX3 9DU, UK.
  • Edward Nicol
    Royal Brompton and Harefield Hospital, Guys and St Thomas' NHS Trust, London, UK.
  • David Adlam
    Department of Cardiovascular Sciences and National Institute for Health Research Leicester Biomedical Research Centre, University of Leicester, Leicester, United Kingdom.
  • Bhavik Modi
    Department of Cardiovascular Sciences, University of Leicester, Leicester, LE1 7RH, UK.
  • Attila Kardos
    Translational Cardiovascular Research Group, Department of Cardiology, Milton Keynes University Hospital, Milton Keynes, United Kingdom; Faculty of Medicine and Health Sciences, University of Buckingham, Buckingham, United Kingdom.
  • John P Greenwood
    Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, and Leeds Teaching Hospitals NHS Trust, UK.
  • Nikant Sabharwal
    Department of Cardiology, Oxford University Hospitals NHS Foundation Trust, John Radcliffe Hospital, Oxford, UK.
  • Giovanni Luigi De Maria
    Acute Multidisciplinary Imaging & Interventional Centre, British Heart Foundation (BHF) Centre of Research Excellence, Division of Cardiovascular Medicine, Radcliffe Department of Medicine, Oxford NIHR Biomedical Research Centre, University of Oxford, John Radcliffe Hospital, Headley Way, Oxford, OX3 9DU, UK.
  • Shahzad Munir
    Royal Wolverhampton NHS Trust, Wolverhampton, WV10 0QP, UK.
  • Elisa McAlindon
    Institute for Cardiovascular Science, University College London, United Kingdom
  • Yogesh Sohan
    Caristo Diagnostics, Oxford, OX2 0HP, UK.
  • Pete Tomlins
    Acute Multidisciplinary Imaging and Interventional Centre, Radcliffe Department of Medicine, University of Oxford, Oxford, United Kingdom; Caristo Diagnostics Pty Ltd, Oxford, United Kingdom.
  • Muhammad Siddique
    Acute Multidisciplinary Imaging and Interventional Centre, Radcliffe Department of Medicine, University of Oxford, Oxford, United Kingdom; Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, United Kingdom; Caristo Diagnostics Pty Ltd, Oxford, United Kingdom.
  • Cheerag Shirodaria
    Department of Cardiology, Oxford University Hospitals NHS Foundation Trust, John Radcliffe Hospital, Oxford, UK.
  • Ron Blankstein
    Department of Medicine (Cardiovascular), Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA.
  • Milind Desai
    Hewlett Packard Enterprise, Houston, TX, USA.
  • Stefan Neubauer
    Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, UK.
  • Keith M Channon
    Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, John Radcliffe Hospital, Headley Way, Oxford, UK.
  • John Deanfield
    National Centre for Cardiovascular Prevention and Outcomes, Institute of Cardiovascular Science, University College London, 1 St Martins Le Grand, London, UK.
  • Ron Akehurst
    Lumanity, Sheffield, S1 2GQ, UK.
  • Charalambos Antoniades
    Acute Multidisciplinary Imaging and Interventional Centre, Radcliffe Department of Medicine, University of Oxford, Oxford, United Kingdom.

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