The striking predictive power of FAI was also independent of ‘high risk plaque features’, currently reported on CCTA scans.

The presence of high-risk plaque features does not predict increased risk in people who have a low FAI, whereas people with a high FAI have higher risk, even in the absence of high-risk plaque features.

Before the clinical manifestations of atherosclerosis become apparent, patient management in primary prevention is based on the control of traditional risk factors (lipids, glucose, blood pressure) and lifestyle education (diet, exercise, smoking cessation).

In secondary prevention, the focus shifts towards symptom relief and the use of non-invasive testing to guide management.

However, over half of acute coronary syndromes occur in patients in whom current diagnostic testing did not reveal evidence of ischemia or a functionally significant coronary artery stenosis.

A CaRi-Heart® report provides comprehensive patient risk stratification for future cardiac events, including:

• The patient’s relative risk of a fatal cardiac event, compared with people of the same age and gender, based on quantification of the coronary inflammation (FAI-Score)

• The absolute risk of a fatal cardiac event within the next 8 years, based on the personalised FAI-Score values, the coronary atherosclerotic plaque burden and clinical risk factors

The CaRi-Heart® analysis significantly improves risk discrimination over clinical risk factor-based models across the full spectrum of cardiac risk. One way to seamlessly integrate it into patient management pathways involving CCTA is outlined below:

Compared with Calcium score, CaRi-Heart® has superior prognostic performance

and tracks dynamic changes in response to treatment

96h post PCI

Optical Medical Therapy 6 months

6 months post PCI