A groundbreaking artificial intelligence system, developed by Oxford University spin-out Caristo Diagnostics, can now identify patients at risk of heart attacks up to a decade before symptoms appear—using only routine cardiac CT scans. This trailblazing tool, known as CaRi-Heart®, assesses coronary inflammation and plaque to generate an eight-year risk estimate, fundamentally changing how cardiologists detect and prevent heart disease.
The system applies advanced AI algorithms to standard coronary CT angiography (CCTA), quantifying coronary inflammation through the patented Fat Attenuation Index (FAI), and evaluating plaque characteristics with the CaRi-Plaque™ module. Studies show that higher FAI scores are associated with a 6–9 times greater risk of fatal heart attack, and a 5 times greater risk of non‑fatal events.
The UK’s National Health Service has launched pilots across five hospital trusts—including Oxford, Leicester, Milton Keynes, Liverpool, and Wolverhampton—where CaRi-Heart’s insights have led to treatment changes in over 45% of patients studied. In up to 45% of these cases, clinicians adjusted medications or treatment plans, including the use of statins and anti-inflammatory therapies.
Dr. Stephen Bloom, a cardiologist at Midwest Heart and Vascular Specialists, highlighted this leap forward:
“We can take patients even before they have symptoms and diagnose whether or not they have early coronary disease and treat them with appropriate medication as well as a change in their diet [and] exercise.”
He emphasizes that, unlike traditional tests that detect disease after narrowing occurs, CaRi-Heart detects inflammation—often the precursor to blocked arteries—offering a proactive approach.
From Early Detection to Healthcare Transformation: Benefits and Outlook
The traditional approach in cardiology has been reactive: treat symptoms once disease has advanced. But Dr. Bloom points out the discrepancy with other fields:
“We do mammograms before people have breast cancer… in cardiology, we wait until they have symptoms, and then we do our best to treat our patient.”
CaRi-Heart changes that paradigm by enabling early detection of inflammation—even when CT scans show no narrowing—when tens of thousands of patients presenting with chest pain are often told their scan was “normal.” Yet statistics show that many such patients suffer cardiac events later.
Utilizing AI and CT imaging, CaRi-Heart interprets subtle changes in perivascular fat and plaque composition—signals invisible to the naked eye. In one Oxford-led study involving 40,000 patients, those flagged by AI had dramatically higher cardiac events, with some showing an 11-fold rise in cardiac mortality risk.
Professor Charalambos Antoniades, head of the Oxford team, remarked:
“Our discovery was to find a way to bring up hidden information by using AI to enhance our CT scan images… now we can.”
He explained that approximately 80% of patients with chest pain receive a “normal” CT result and are sent home; yet many of them continue to face high future risk . The AI system successfully flagged patients who otherwise would have been overlooked and influenced treatment decisions in nearly half of detected cases .
From a cost perspective, the British Heart Foundation and UK studies concluded that the approach is highly cost-effective, as it can prevent heart attacks and strokes, reducing hospital admissions and chronic care expenses .
Furthermore, Caristo’s FDA approval of its CaRi-Plaque™ tool in the U.S., along with new CPT reimbursement codes, reinforces the viability and clinical integration of this technology.
A Turning Point in Cardiac Care
The integration of AI-based inflammation detection into routine cardiac imaging marks a milestone in medical practice. By shifting from reactive to preventative cardiac care, CaRi-Heart represents a potential revolution in how heart disease is managed—catching risk early, guiding targeted treatment, and saving lives.
If UK-wide NHS approval is forthcoming, followed by broader adoption in Europe and the U.S., this AI strategy could reshape cardiology, parallel breakthroughs in oncology and neurology, and firmly establish AI-enhanced diagnostics as a standard of care.
As Professor Antoniades aptly stated:
“If installed nationally, it would help save thousands of people from suffering early heart attacks or deaths from heart disease.”
The coming years may well see CaRi-Heart and similar AI systems becoming key tools in the global fight against cardiovascular disease.
