Southampton cardiac charity funds AI study to identify heart attack patients at risk of more events

Professor Nick Curzen of University Hospital Southampton

A Southampton-based cardiac charity has helped to fund a study that uses advanced AI heart scan technology to identify patients most at risk of dying or having a further heart attack after they have been treated for a heart attack.

Heartbeat, in conjunction with two other research companies, have funded the PICNIC study of STEMI patients – a type of heart attack that occurs when a major artery feeding into the heart is completely blocked and in whom the modern treatment is emergency angioplasty to reopen the blocked artery as soon as possible.

Around 50% of patients with STEMI also have bystander narrowings in their other coronary arteries. Whilst the evidence base shows very clearly that the artery causing the heart attack should be stented as soon as possible, it remains controversial how the bystander narrowings should be treated. Current guidelines recommend that all such narrowings should be stented within a few weeks of the first heart attack... but this recommendation has not proved popular with cardiologists because there are many flaws in the strategy. In particular, it is obvious that most of the bystander narrowings will not go on to cause a further event, so that trying to stent all of them seems illogical.

PICNIC is investigating which of these bystander narrowings are most likely to cause future heart attacks and other events. The study uses two advanced AI imaging technologies – Heart Flow Plaque Analysis and the Caristo Fat Attenuation Index – which  analyse CT coronary angiography scans. In other groups of patients, these technologies have already shown promise in predicting which artery narrowings are more likely to lead to future heart attacks or death.

So far, 52 patients have been recruited toward the target of 320 participants. Recruitment is currently active at University Hospital Southampton, Royal Bournemouth Hospital, Imperial College London, and Stoke. Queen Alexandra Hospital Portsmouth will be joining imminently and 2 sites in South Korea are also preparing to become recruiting centres.

Thanks to the support of Heartbeat, the Coronary & Structural Heart Research Group, led by Professor Nick Curzen and Michael Mahmoudi, has established an international PICNIC Study Group involving colleagues from University of Oxford, Seoul National University, Imperial College London, University of Keele, Royal Bournemouth Hospital.

Nick Curzen commented: “The PICNIC study is bringing together world-leading expertise and advanced AI imaging technologies to help us personalise treatment decisions for STEMI patients with bystander disease. We are extremely grateful to Heartbeat and our research partners for supporting this important work.”

CEO of Heartbeat, Mark Ind, said: “At Heartbeat, we are proud to support research that has the potential to directly improve patient care and save lives. The PICNIC study is an exciting example of how innovation, collaboration and advanced technology can work together to deliver more personalised treatment for people recovering from serious heart attacks.”