Overall summary
CaRi-Heart® is medical imaging analysis software that uses artificial intelligence (AI) technology to analyse images from computed tomography coronary angiography (CTCA) which can predict cardiac risk in patients with suspected coronary artery disease (CAD).
The AI software measures the perivascular fat attenuation index (FAI) which is integrated with clinical factors to generate an eight-year cardiac risk estimate. CaRi-Heart® can detect coronary inflammation before artery narrowing has developed, years before an attack may occur. This information can assist clinicians to inform and guide individual treatment decisions, potentially leading to a reduction in heart attacks and cardiac deaths.
According to the British Heart Foundation, CAD is the most common cause of premature death, with approximately 25,000 premature deaths annually.
The Oxford AHSN worked with Caristo Diagnostics on a feasibility study into the CaRi-Heart® technology to assess the potential clinical utility and value of using CaRi-Heart® in the current pathway.
What is the challenge?
In the United Kingdom, 2.3 million people are living with CAD, a leading cause of death accounting for an estimated 66,000 deaths every year. There is currently no cure for CAD, but treatment is available to help manage the symptoms and reduce further complications. Earlier identification of patients with CAD would facilitate the deployment of risk factors modifying therapies which could reduce rates of morbidity and mortality.
What did we do?
The Oxford AHSN carried out a feasibility study by interviewing key stakeholders from primary, secondary and tertiary care involved in assessing, diagnosing and managing patients with suspected CAD to investigate the potential clinical utility, benefits and barriers to adopting CaRi-Heart® into the NHS care pathway for chest pain assessment.
What has been achieved?
The Oxford AHSN feasibility study evaluated the technology’s utility in the NHS care pathway for chest pain management. Stakeholders who were interviewed agreed that current technologies for detecting coronary artery inflammation are either non-specific for the cardiovascular system, expensive and/or not readily available. The stakeholders were of the view that use of the perivascular fat attenuation index (FAI) novel imaging biomarker could enable the detection of coronary inflammation when applied to CTCA scans.
What people said
“The insights provided by the interviews conducted by the Oxford AHSN team were extremely helpful to Caristo, providing us with important feedback from different stakeholders within the NHS on our CaRi-Heart® technology.”
Dr Cheerag Shirodaria, co-founder and Chief Development Officer, Caristo Diagnostics
What next?
CaRi-Heart® underwent NICE Early Value Assessment in March 2023. Following this, NHS England initiated a six-month multi-site pilot across four NHS hospitals in Oxford, Leicester, Milton Keynes, and Wolverhampton. These pilot studies will provide valuable insights into the real-world effectiveness and feasibility of CaRi-Heart®.
Contact
Mamta Bajre, Lead Health Economist & Methodologist mamta.bajre@oxfordahsn.org