Artificial intelligence can predict risk of heart attack

By Stephen Beech

A tiny camera coupled with AI technology can accurately predict the risk of a second heart attack, according to new research.

The miniature camera takes measurements inside the patient's coronary arteries, say scientists.

Interpreting those images, until now, was so complex that only specialized laboratories could perform it.

But the new study by Dutch scientists shows that AI can "reliably" take over the analysis and rapidly assess arteries for weak spots.

The researchers explained that a heart attack occurs when a coronary artery, which supplies the heart with blood, is blocked by a blood clot.

That can occur when atherosclerosis causes artery narrowing, resulting in the heart receiving too little oxygen.

Treatment usually involves angioplasty - where a cardiologist widens the artery with a small balloon - usually followed by the placement of a tiny tube, called a stent.

But around 15% of patients who suffer a heart attack experience another event within two years.

To better identify vulnerable spots within the artery that can trigger another heart attack, researchers at Radboud University Medical Center analyzed the coronary arteries of 438 patients using a miniature camera and specially developed AI, and followed those patients for two years.

The study, published in the European Heart Journal, shows that AI detects vulnerable spots in the arterial wall just as well as specialized labs - the international "gold standard" - and even predicts further heart attacks or death within two years more accurately.

Study co-author Dr. Rick Volleberg said: "If we know who has high-risk plaques and where they are located, we may in the future be able to tailor medication or even place preventive stents."

He explained that the miniature camera uses a technique called optical coherence tomography (OCT).

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Inserted through the arm into the bloodstream, it captures images of arteries using near-infrared light, visualising the vessel wall at microscopic resolution.

Co-author, technical physician Dr. Jos Thannhauser said: "This technique is already used in clinical practice to guide angioplasty and to check whether a stent has been placed correctly.

"It has been shown that OCT reduces the risk of new infarctions and complications.

"But in those cases, physicians only look at a very small part of an artery - the site of the infarction.

"Our study shows that this technique, combined with AI, has much greater potential to map entire vessels.

"One of the challenges with this technique is that it is extremely difficult for physicians to interpret OCT images."

The researchers explained that each procedure produces hundreds of images, so even assessing just the stent placement is "challenging".

Analysing entire coronary arteries produces far too many images to evaluate manually.

Dr. Thannhauser said: "Currently, only a handful of specialized labs can interpret these images, and even they cannot review everything.

"Moreover, it’s too expensive and labor-intensive to implement this manually in routine clinical care."

That is why the team developed an AI that can analyze all images reliably and much faster than humans.

Dr. Thannhauser added, "AI can already assist physicians during stent placement with OCT.

"Thanks to our AI, we are now a step closer to scanning entire coronary arteries for vulnerable spots in clinical practice.

"I do expect, however, that it will take a number of years before this becomes reality."