By identifying high risk plaque patterns that are difficult to measure with the unaided eye during routine CT calcium scoring a new artificial intelligence tool, could improve the way clinicians identify heart attack risk.
Coronary artery calcium (CAC) scoring, a CT based test that calculates the amount of calcified plaque in the coronary arteries, is the foundation of this work.
The most popular technique, the Agatston score has become a standard indicator of future cardiovascular risk, but it can be difficult to distinguish between stable calcification and more hazardous patterns.
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The new algorithm, which was developed by The University of Western Australia, the Harry Perkins Institute of Medical Research, Fiona Stanley Hospital and Perth med tech company Artya, is called the CAC.
Dispersion and density score, or CAC DAD and it takes into account the location of the plaque, as well as the spatial distribution of calcium while also providing a protective weighting for very dense lesions, which may be more stable.
In a study of 961 patients who had undergone cardiac CT for cardiovascular risk assessment or perioperative evaluation, major adverse cardiovascular events, such as nonfatal heart attack or cardiovascular death were tracked over a median of 30 days.
During which time, 74% of such events were detected by a high CAC DAD score, whereas only 57% of such events were detected by a commonly used high risk Agatston score.
In a UWA statement, first author Dr. Gavin Huangfu stated that “analysis of each individual plaque, which is not feasible for a human investigator.”
“Prevention is still the best course of action” stated senior author Professor Girish Dwivedi.
The score still requires prospective testing and validation in lower risk patients before it can be routinely implemented in clinics.
The development occurs at a time when coronary heart disease is still one of Australia’s top causes of death and medical professionals are still debating how to increase the use of CAC scoring locally, including concerns about funding and access.
