Implementation of a national AI technology program on cardiovascular outcomes and the health system.

Fairbairn, TA.; Mullen, L.; Nicol, E.; Lip, GYH.; Schmitt, M.; Shaw, M.; Tidbury, L.; Kemp, I.; Crooks, J.; Burnside, G.; Sharma, S.; Chauhan, A.; Liew, C.; Waidyanatha, S.; Iyenger, S.; Beale, A.; Sunderji, I.; Greenwood, JP.; Motwani, M.; Reid, A.; Beattie, A.; Carter, J.; Haworth, P.; Bellenger, N.; Hudson, B.; Rodrigues, J.; Watson, O.; Venugopal, V.; Bull, R.; O'Kane, P.; Deshpande, A.; McCann, GP.; Duckett, S.; Mansoubi, H.; Parish, V.; Sehmi, J.; Rogers, C.; Mullen, S.; Weir-McCalL, J.

Implementation of a national AI technology program on cardiovascular outcomes and the health system.

All Authors

Fairbairn, TA.

Mullen, L.

Nicol, E.

Lip, GYH.

Schmitt, M.

Shaw, M.

Tidbury, L.

Kemp, I.

Crooks, J.

Burnside, G.

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LTHT Author

Greenwood, John

LTHT Department

Cardio-Respiratory
Cardiology

Publication Date

2025

Item Type

Journal Article
Observational Study

Abstract

Coronary artery disease (CAD) is a major cause of ill health and death worldwide. Coronary computed tomographic angiography (CCTA) is the first-line investigation to detect CAD in symptomatic patients. This diagnostic approach risks greater second-line heart tests and treatments at a cost to the patient and health system. The National Health Service funded use of an artificial intelligence (AI) diagnostic tool, computed tomography (CT)-derived fractional flow reserve (FFR-CT), in patients with chest pain to improve physician decision-making and reduce downstream tests. This observational cohort study assessed the impact of FFR-CT on cardiovascular outcomes by including all patients investigated with CCTA during the national AI implementation program at 27 hospitals (CCTA n = 90,553 and FFR-CT n = 7,863). FFR-CT was safe, with no difference in all-cause (n = 1,134 (3.2%) versus 1,612 (2.9%), adjusted-hazard ratio (aHR) 1.00 (0.93-1.08), P = 0.97) or cardiovascular mortality (n = 465 (1.3%) versus 617 (1.1%), aHR 0.96 (0.85-1.08), P = 0.48), while reducing invasive coronary angiograms (n = 5,720 (16%) versus 8,183 (14.9%), aHR 0.93 (0.90-0.97), P < 0.001) and noninvasive cardiac tests (189/1,000 patients versus 167/1,000), P < 0.001). Implementation of an AI-diagnostic tool as part of a health intervention program was safe and beneficial to the patient pathway and health system with fewer cardiac tests at 2 years.