A study of hemodynamic data from HeartFlow, Inc., led by Bon-Kwon Koo, MD, PhD, of Seoul National University Hospital, may help predict which coronary plaques have the potential to rupture. Analyzing HeartFlow technology, the study was designed to predict the risk of developing acute coronary syndrome (ACS), a condition associated with sudden, reduced blood flow to the heart.
ACS is responsible for the hospitalization of nearly 1.4 million Americans each year, of which 810,000 are for myocardial infarction. Plaque rupture causes approximately 75 percent of fatal myocardial infarctions.
The EMERALD (Exploring the Mechanism of the plaque Rupture in Acute coronary syndrome using coronary CT angiography and computational fluid Dynamics) study evaluated 71 patients who experienced ACS and who had received a coronary CT angiography (cCTA) between one month and two years previously.
“When evaluating a patient for risk of ACS, we need to look at not only the burden and composition of the plaque, but also the hemodynamic forces - or stress - placed upon the lesion,” Koo said. “The EMERALD study has demonstrated that by applying this important measurement we may have the potential to greatly improve prediction of the lesions that cause ACS, which could help us optimize treatment strategies for these high-risk patients.”
The HeartFlow’s hemodynamic assessment analyzed a total of 226 coronary plaques from the cCTAs and showed APCs increased the discrimination of lesions at risk for causing ACS more than 10 percent over lesion severity alone. The study concluded that using HeartFlow’s hemodynamic assessment was a better predictor of which plaques would rupture and lead to ACS than percent diameter stenosis or adverse plaque characteristics (APCs).
“EMERALD is an exciting study, which demonstrates that HeartFlow technology may have prognostic applicability beyond aiding in the improved diagnosis of ischemia,” said John H. Stevens, MD, chairman and CEO of HeartFlow. “The findings provide important clinical insights to help identify at-risk ACS patients and has the potential to save many lives.”
The HeartFlow FFR Analysis, is the only non-invasive technology to provide insight into both the extent of coronary artery disease and the impact that disease has on blood flow to the heart, therefore enabling clinicians to select an appropriate treatment. The hemodynamic factors tested in the EMERALD study include those in the HeartFlow FFR Analysis, which involves the creation of a patient-specific anatomic model from medical imaging data and the application of Computational Fluid Dynamics.