STEMI is a type of heart attack that occurs when a major artery feeding into the heart is completely blocked. The best treatment for this is to perform an emergency angioplasty to restore flow in the blocked artery (culprit artery) – the treatment for this is unequivocal.
However, approx. 50% of patients with STEMI also have coronary artery disease (CAD), which are narrowing’s of other coronary arteries (non-culprit vessels) – the treatment for this is uncertain.
Heartbeat, in conjunction with 2 other research companies have agreed to fund a PICNIC study which would enable the personalised care of these patients to identify who are at risk of another heart attack that would benefit from complete revascularisation (stenting), but also identify low risk patients who would not need this invasive treatment.
PICNIC aims to try to establish which of the bystander narrowings will actually go on to cause another acute event, by applying 2 state of the art, artificial intelligence-enabled imaging systems: HeartFlow Plaque analysis and Caristo Fat Attenuation Index. Both of these imaging systems use the data from CT coronary angiography to produce data that has been shown in other patient populations to be able to predict which coronary narrowings are likely to cause further heart attack and death.
Thanks to the generosity of Heartbeat, working in collaboration with two other research organisations, the Coronary & Structural Heart Research Group, led by Profs Curzen & Mahmoudi has been able to set this international collaboration up (including colleagues at Oxford & Seoul Universities, & Imperial College in London).
The study continues to make encouraging progress, with a total of 52 patients now recruited toward our target of 320. Recruitment is actively ongoing across several key sites, including University Hospital Southampton (UHS), Royal Bournemouth Hospital, Imperial College London, and Stoke.
QA Portsmouth has now received approval to open and is awaiting formal site initiation. Internationally, activity is also progressing well, with South Korea currently in active discussions with three sites as preparations continue for opening.
The Study Steering Committee met beginning of May 2026 and approved a substantial amendment to extend the recruitment period until 28 June. The committee also recommended engagement, via one of our independent experts, with Professor Koo in Korea to help facilitate progress with site activation. In addition, plans are underway to open at least two further UK sites, potentially Oxford and Newcastle, alongside encouraging existing principal investigators to explore local strategies to further enhance recruitment activity.