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 & Soeul Universities, & Imperial College in London). So far, 13 patients have been recruited across the initial two sites: Southampton and Bournemouth. Plans are now underway to expand the study to additional centres, with Imperial London and Stoke set to open soon, and Portsmouth recently invited to join as a recruiting centre. PICNIC has the potential to challenge the way these heart attack patients are treated in the future.