Cedars-Sinai Investigators Use AI to Analyze Plaques That Cause Cardiovascular Disease
Age- and Sex-Specific Thresholds for Coronary Plaque Could Guide Patients
Artery-clogging plaque can lead to a heart attack, and artificial intelligence (AI) may help physicians advise patients about their risk, according to a new Cedars-Sinai study.
The study, published in Circulation: Cardiovascular Imaging, details how investigators trained a deep learning program to look for patterns in a commonly used heart test called computed tomography angiography. The results showed that plaque volumes increased with age and were higher in male patients. Women presented with lower plaque volumes compared to men of the same age. Patients in higher percentiles for plaque volume (which takes into account these differences in age and gender) were more likely to experience a heart attack.
Patients typically have a computed tomography angiography for chest pain. The AI software can measure plaque in the coronary arteries and also provide a percentile score for a patient’s age and gender.
When plaque builds up in the arteries, it can lead to a condition called atherosclerosis, in which arteries harden and narrow. If blood supply to the heart is reduced, a heart attack may result. The condition also can lead to heart failure, stroke and loss of limbs.
“The use of AI to measure coronary plaques will significantly influence clinical practice,” said Damini Dey, PhD, professor of Biomedical Sciences at Cedars-Sinai and corresponding author of the study. “In addition to telling a patient their total plaque volume, it may be easier to understand their heart attack risk from plaque volumes relative to other patients of similar age and sex.”
Other Cedars-Sinai authors involved in the study include Robert J.H. Miller, MD; Nipun Manral, MSc; Andrew Lin, MBBS, PhD; Aakash Shanbhag, MSc; Caroline Park, BSc; Aditya Killekar, MSc; Priscilla McElhinney, BSc; Aryabod Razipour, MD; Kajetan Grodecki, MD, PhD; Alan C. Kwan, MD; Donghee Han, MD; Keiichiro Kuronuma, MD; Guadalupe Flores Tomasino, MD; Jolien Geers, MD; Heidi Gransar, MSc; Sebastien Cadet, MSc; Daniel S. Berman, MD; and Piotr J. Slomka, PhD.
Other authors include Jacek Kwiecinski, MD, PhD; Aditya Killekar, MSc; Hidenari Matsumoto, MD, PhD; Aryabod Razipour, MD; Markus Goeller, MD; Mohamed Marwan, MD; MSc; Balaji K. Tamarappoo, MD, PhD; Victor Y. Cheng, MD; Stephan Achenbach, MD; Stephen J. Nicholls, MBBS, PhD; Dennis T. Wong, MD, PhD; Lu Chen, MD; J. Jane Cao, MD; Marc R. Dweck, MBChB, PhD; David E. Newby, MD, PhD; Michelle C. Williams, MBChB, PhD.
Dr. Miller has received consulting fees and research support from Pfizer. S. Cadet, Dr. Slomka, Dr. Dey, and Dr. Berman received software royalties from Cedars-Sinai Medical Center and report equity in APQ Health Inc. outside of the current work. Dr. Berman, Dr. Slomka, and Dr. Dey hold a patent (US8885905B2/WO2011069120A1, Method and System for Plaque Characterization). Dr. Grodecki reports grants or contracts from the Foundation for Polish Science and Polish Society of Cardiology. Dr. Kwan reports partial effort support from the Doris Duke Charitable Foundation Grant. Dr. Kuronuma is supported by grants from The Society of Nuclear Medicine and Molecular Imaging Wagner-Torizuka Fellowship and Nihon University School of Medicine Alumni Association .S. Cadet reports financial support from the Miriam and Sheldon G Adelson Medical Research Foundation Grant. Dr. Nicholls reports grants or contracts from AstraZeneca, New Amsterdam Pharma, Amgen, Anthera, Eli Lilly, Esperion, Novartis, Cerenis, The Medicines Company, Resverlogix, InfraReDx, Roche, Sanofi-Regeneron, and LipoScience; and consulting fees from AstraZeneca, Amarin, Akcea, Eli Lilly, Anthera, Omthera, Merck, Takeda, Resverlogix, Sanofi-Regeneron, CSL Behring, Esperion, and Boehringer Ingelheim. Dr Dweck reports consulting fees from Novartis, Jupiter Bioventures, and Silence Therapeutics; and payment or honoraria from Pfizer and Novartis. Dr. Newby reports a grant from the British Heart Foundation (RE/24/130012, CH/09/002, and RG/F/22/110093) and Wellcome Trust. Dr. Williams has given talks for Canon Medical Systems, Siemens Healthineers and Novartis. The other authors report no conflicts.
The study was supported by grants from the National Heart, Lung, and Blood Institute, USA (1R01HL148787–01A1 and R01HL151266), the Miriam & Sheldon G Adelson Medical Research Foundation, and a grant from the Winnick Family Foundation.
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