A Single Chest X-ray Might Predict Your Risk of Heart Attack or Stroke Within a Decade

Preventing a stroke or heart attack before you have one could prevent death and disability. New research uses artificial intelligence to analyze a chest x-ray to determine your ten-year risk, allowing doctors to treat it beforehand.
Updated: December 19th, 2022
Linda Maxwell

Contributor

Linda Maxwell

A new computer system can forecast a patient's likelihood of having a heart attack or stroke within the next ten years with just one chest X-ray.

According to researchers from the Radiological Society of North America, a standard X-ray is combined with AI (artificial intelligence) to detect patterns linked to artery hardening. The method raises hopes that physicians can give cholesterol-lowering medications to at-risk folks before it's too late.

Researchers have developed a deep learning model that uses a single chest X-ray to predict whether someone may be at risk of death from a heart attack or stroke stemming from atherosclerotic cardiovascular disease in the next ten years.

Deep learning is an advanced type of artificial intelligence (AI) that can be trained to search X-ray images to find patterns associated with the disease. Jakob Weiss, M.D., a radiologist affiliated with the Cardiovascular Imaging Research Center at Massachusetts General Hospital and the AI in Medicine program at the Brigham and Women's Hospital in Boston, says this model offers a potential solution for population-based opportunistic screening of cardiovascular disease risk using existing chest X-ray images.

This type of screening could be used to identify individuals who would benefit from statin medication but are currently untreated.

Current guidelines recommend estimating a 10-year risk of major adverse cardiovascular disease events to establish who should get a statin for primary prevention.

Dr. Weiss and a team of researchers trained a deep-learning model using a single chest X-ray (CXR) input. 

Dr. Weiss

We've long recognized that X-rays capture information beyond traditional diagnostic findings, but we haven't used this data because we haven't had robust reliable methods. Advances in AI are making it possible now.

Dr. Weiss says that the benefit of this approach is that the doctor only needs an X-ray, which is acquired millions of times a day across the world.

Based on a single existing chest X-ray image, our deep learning model predicts future major adverse cardiovascular events with similar performance and incremental value to the established clinical standard.

X-Ray Could Be Key Tool for Doctors

Dr. Weiss said additional research, including a controlled, randomized trial, is necessary to validate the deep learning model. Ultimately this can be a tool used by doctors as they treat their patients. 

What we've shown is a chest X-ray is more than a chest X-ray. With an approach like this, we get a quantitative measure, which allows us to provide both diagnostic and prognostic information that helps the clinician and the patient.

Treating individuals before they have a stroke or heart attack can do more than just prevent death. Strokes and heart issues often cause a need for long-term health care in older people. Long-term health care can be very costly.

These costs are usually not covered by health insurance or Medicare. Only Long-Term Care Insurance and Medicaid will pay for long-term care services. However, you must purchase LTC Insurance when you are healthy. Medicaid requires an individual to have little or no income and assets.

Long-Term Care Insurance is medically underwritten, but you don't have to have perfect health. Being treated and stabilized would allow someone to obtain coverage, depending on the situation. Regular check-ups and preventative medications, like cholesterol drugs, can reduce the risk of severe health problems. It also allows more people to plan with LTC Insurance for aging and health problems that lead to long-term health care.

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