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An Oxford University spinout led by RDM's Professor Charlambos Antoniades utilises standard CT scans to identify a potentially fatal build-up of plaques that could trigger a heart attack.

Caristo Diagnostics commercialises a new coronary CT image analysis technology that can flag patients at risk of deadly heart attacks years before they occur.


For the first time we have a set of biomarkers, derived from a routine test used anyway as part of everyday clinical practice, that measures what we call ‘the residual cardiovascular risk’, currently missed by all risk scores and non-invasive tests.  - Professor Charlambos Antoniades, Caristo Diagnostics founder


Every year, over 100,000 people die from a heart attack or related stroke in the UK alone, and heart disease and stroke remain the two biggest overall causes of death worldwide.

Heart attacks are often caused by inflamed plaques dislodging from the coronary artery and blocking blood getting to the heart. Yet there is no method that allows for early detection of a potentially fatal build-up of plaque that could trigger a heart attack.

Caristo’s technology, which has been developed as part of a research collaboration led by RDM researchers, is based on the novel scientific discovery that the fat tissue surrounding the coronary arteries senses the presence of inflammation in the coronary artery.

This change can be detected by analysis of routine coronary CT angiograms (CCTA) using Caristo’s proprietary technology, producing a new measure called the Fat Attenuation Index (FAI) which accurately quantifies the extent of inflammation in the coronary arteries supplying the heart.

A cardiac risk score

The FAI can be combined with other known risk factors and imaging characteristics to create a new Cardiac Risk score (CaRi), which provides a greater level of prognostic insight compared to any existing risk-assessment biomarker. meaning that clinicians would be able to identify early those people who are at risk of having a heart attack and take preventative steps, such as lifestyle modification and initiating preventive medication.

Caristo’s technology is hardware agnostic and can be assessed on any standard CCTA. This includes existing CCTAs, giving clinicians the opportunity to re-evaluate a patient’s future risk of having a heart attack.

The company’s launch comes shortly after a study into FAI, which is based on analysis of over 3,900 patients in both Europe and the United States and includes follow up data for up to a decade, was published in the Lancet in August. At the same time, Professor Charalambos Antoniades, inventor of the FAI technology who led the study, presented his findings at the European Society of Cardiology Congress.

Professor Charalambos Antoniades, Professor at RDM's Division of Cardiovascular Medicine and Founder of Caristo Diagnostics, said:

“This new technology may prove transformative for primary and secondary prevention. For the first time we have a set of biomarkers, derived from a routine test used anyway as part of everyday clinical practice, that measures what we call ‘the residual cardiovascular risk’, currently missed by all risk scores and non-invasive tests. Knowing who is at high risk for a heart attack, could allow us to intervene early enough to prevent it. I expect these biomarkers to become essential part of standard coronary CT angiography reporting in the coming years.”

Dr Victoria Sanchez, Senior Licensing and Ventures Manager at Oxford University Innovation, added:
“Heart disease remains the world’s biggest killer – claiming over a hundred thousand lives every year in the UK alone. In many cases, these deaths could be avoided, yet instead are treated reactively after the damage has been done. This technology has the potential to give doctors unparalleled insight into their patients’ prognosis, and make informed treatment decisions with a greater level of confidence. Caristo turns the battle against heart disease from reactive to preventative, increasing chances of avoid a fatal cardiac incident and saving billions in cardiac care while being relatively inexpensive for hospitals to implement”

Professor Metin Avkiran, Associate Medical Director at the British Heart Foundation, which funded the research that developed FAI, added:
“Most heart scans are good at spotting blockages caused by large plaques, but not the smaller, high-risk plaques that are likely to rupture and cause a heart attack. This new technique could be a game changer – allowing doctors to spot those “ticking time bomb” patients who are most at risk of a heart attack, and getting them on to intensive treatment. This would undoubtedly save lives. By using this non-invasive scan, we could prevent a lurking heart attack that might occur down the road. But it also potentially gives us a real-time window into tracking the effect of drugs on inflamed arteries, helping us to identify new life-saving therapies.”

Find out more about Caristo Diagnostics.

Find out more about the technology behind Caristos Diagnostics, and read the Reuters article about this work.