CCTA with CaRi-Heart® and CaRi-Plaque™: A Guide for Healthcare Professionals

Caristo Diagnostics, a global leader in AI technologies for cardiovascular disease, brings 2 AI-powered analysis tools — CaRi-Heart and CaRi-Plaque — to provide additional information when used alongside CT coronary angiography (CCTA) images, supporting the assessment of cardiovascular risk and coronary plaque.

Vista Health is proud to partner with Caristo Diagnostics to offer two advanced analysis tools that provide additional information from your existing CCTA scan, helping doctors better understand your heart health.

Here, we will explore the valuable information these analyses add to CCTA, how this is presented to referring clinicians and how you can refer a patient for CCTA with CaRi-Heart and/or CaRi-Plaque analysis at Vista Health. 

What Can CaRi-Heart Add to CCTA?

Assessing Coronary Inflammation

CaRi-Heart® analysis uses coronary artery inflammation as a marker for cardiovascular risk, namely major adverse cardiovascular events (MACE), such as myocardial infarction, new onset heart events and cardiac mortality.

The evidence linking inflammation with atherosclerotic cardiovascular disease is increasingly seen as a marker that needs clinical action, as announced in a 2025 Scientific Statement from the American College of Cardiology (ACC). This is especially important for patients who do not show signs of coronary artery obstruction on CCTA.

In the Oxford Risk Factors And Non-invasive imaging (ORFAN) study, which supports CaRi-Heart and is the world's largest coronary CT registry following long-term outcomes from up to 250,000 patients, patients without obstructive coronary artery disease accounted for around two-thirds of MACE during follow-up.

The ORFAN study went on to show that CaRi-Heart analysis for coronary artery inflammation accurately predicted “cardiac mortality and MACE independently from cardiovascular risk factors and the presence or severity of coronary artery disease”.

How Does it Work?

CaRi-Heart uses AI-enabled analysis of CCTA images. It analyses the fat surrounding coronary arteries to assess changes caused by the release of inflammatory chemicals by the adjacent coronary artery.

This generates a Fat Attenuation Index (FAI) Score™, which is Caristo's proprietary biomarker of coronary inflammation. The FAI Score™ is used to generate the CaRi-Heart Risk score, which provides an estimate of cardiovascular mortality risk for an individual over the next 8 years.

This additional prognostic information can be used alongside CCTA findings to provide a more comprehensive assessment of cardiovascular risk.  

What Can CaRi-Plaque™ Add to CCTA?

Conventional CCTA images provide information on plaque volume, type and stenosis severity.

CaRi-Plaque provides AI-driven precision analysis of coronary plaques. It accurately detects coronary plaques and provides quantitative analysis, including plaque volume, characteristics and stenosis severity. This builds a more detailed picture of the extent of coronary artery disease.

As with CaRi-Heart, CaRi-Plaque uses AI-enabled analysis of existing CCTA images to carry out fully automated plaque detection and assessment.  

What Information Does the Referring Clinician Receive?

In addition to conventional CCTA findings, CaRi-Heart and CaRi-Plaque provide additional information as part of a patient’s overall clinical assessment.

CaRi-Heart

A referring clinician will receive the below information following CaRi-Heart® analysis: 

• FAI Score™ — to quantify coronary inflammation across the 3 main coronary arteries

• CaRi-Heart Risk score — to provide an individualised estimate of cardiac mortality risk over 8 years, based on the FAI Score™, plaque burden and clinical risk factors (eg blood pressure, cholesterol levels and diabetes).
  
  

CaRi-Plaque

A referring clinician will receive the below information following CaRi-Plaque analysis: 

• Maximum stenosis

• Total plaque volume

• Calcified plaque (CP) volume

• Non-calcified plaque (NCP) volume

• Low-density non-calcified plaque (LD-NCP) volume

• Plaque burden

• Remodelling index (how the outer diameter of a coronary artery has changed at the site of a plaque compared to a healthy reference section)

The Referral Pathway

1. Referral and clinical review

To refer a patient for CCTA with CaRi-Heart and/or CaRi-Plaque analysis, simply use Vista Health’s streamlined online referral platform. You will be guided through each section of the referral form to ensure nothing is missed. The referral form will also capture the clinical information needed for the CaRi analysis.

Then, our clinical team will review your referral and confirm the appropriate care pathway. 

2. CCTA scan

Your patient will be contacted by our Patient Care Team to arrange their CCTA at a Vista Health centre. CaRi-Heart and/or CaRi-Plaque analysis is available at selected centres. Once completed, the CCTA images will be ready for additional CaRi analysis.

3. Advanced analysis

The CCTA images are analysed using Caristo's AI-enabled technology to assess coronary plaques, stenosis and/or inflammation, depending on the analysis requested.

4. Report and findings

As the referring clinician, you will receive the CCTA report together with the relevant CaRi analysis, providing additional information to support your clinical assessment.

Your Referral Options

When it comes to CCTA with CaRi analysis, you have 3 options for referral: 

• CT Cardiac angiogram + CaRi-Heart

• CT Cardiac angiogram + CaRi-Plaque

• CT Cardiac angiogram + CaRi-Heart & CaRi-Plaque

In each case, no additional scanning is required. If your referral is accepted, your patient will undergo CCTA as standard and CaRi analysis will be performed afterwards on the CCTA images.

Referral for CCTA with CaRi-Heart and/or CaRi-Plaque analysis can be made by a GP, consultant or other appropriate registered healthcare professional, such as a specialist cardiac nurse.

If you have questions about Vista Health’s referral process, call our friendly Patient Care Team on 0333 200 2064. Lines are open Monday to Friday, 8am to 8pm and on Saturday and Sunday, 8am to 1pm. 

Who Are Caristo Diagnostics?

Caristo Diagnostics was founded by cardiologists at the University of Oxford in 2018 with the goal of revolutionising cardiovascular diagnosis and treatment. Today, it is a global leader in AI technologies for cardiovascular disease with its award-winning CaRi analysis technology. Caristo Diagnostics works with leading hospitals, research institutions and pharmaceutical partners to enable early detection and personalised prevention. In 2026, the company was named a Technology Pioneer by the World Economic Forum.

Are You Ready to Refer? 

If you have a patient who could benefit from additional analysis of their CT coronary angiography images, refer them to Vista Health for CCTA with CaRi-Heart, CaRi-Plaque or both.