FFRCT Study Reveals Prognostic Value, Cost Savings

Dec. 11, 2025 — Heartflow, Inc., a provider of AI technology for coronary artery disease (CAD), recently announced two new analyses from FISH&CHIPS, a real-world, multicenter, retrospective study of more than 90,000 patients conducted by the National Health Service (NHS) in England, representing the largest fractional flow reserve (FFR_CT) study ever conducted.

The data, presented at the European Society of Cardiology’s European Association of Cardiovascular Imaging (EACVI) conference in Vienna, provide the strongest real-world evidence to date that Heartflow FFR_CT Analysis derived from coronary computed tomography angiography (CTA) improves diagnostic decision-making, predicts future cardiovascular events, and delivers substantial, system-wide cost savings.

“These real-world data show that coronary CTA plus Heartflow FFR_CT Analysis brings both clinical and economic value when utilized in a large health system,” said Timothy Fairbairn, Ph.D., principal investigator for the FISH&CHIPS study, Liverpool Heart and Chest Hospital, and Associate Professor at the University of Liverpool, UK. “The introduction of Heartflow FFR_CT Analysis into the NHS resulted in fewer avoidable tests, lower inpatient and outpatient costs, and substantial overall savings for both the hospitals and patients. It’s a compelling example of how noninvasive AI-powered technology can reshape care pathways at scale.”

Predicting Individual Cardiovascular Outcomes

In a nationwide analysis of 7,836 patients who underwent FFR_CT in the FISH&CHIPS study, investigators evaluated the prognostic value of Heartflow FFR_CT Analysis across individual outcomes, including myocardial infarction (MI), cardiovascular mortality, all-cause mortality, and revascularization. Key findings include:¹

The lower the FFR_CT values, the higher the risk of MI, revascularization, cardiovascular death, and all-cause death, independent of traditional cardiovascular risk factors.
Patients with the lowest FFR_CT values faced a four-fold increased risk of heart attack and a three-fold increased risk of cardiovascular death.
Lesion-specific FFR_CT (measured just beyond a specific stenosis) was the strongest predictor in the study of MI and revascularization, compared to distal vessel FFR_CT (measured at the end of the artery).

Delivering Cost Savings

A separate analysis of FISH&CHIPS data evaluated the cost-effectiveness of incorporating Heartflow FFR_CT Analysis into the diagnostic pathway for stable CAD. The findings showed that the national program:²

Reduced downstream cardiovascular testing, including invasive coronary angiography.
Increased appropriate revascularization and improved revascularization ratios.
Produced £1,042 GBP ($1,394 USD) in per-patient cost savings at two years, substantially exceeding the cost savings modeled by NHS and the National Institute for Health and Care Excellence (NICE) during initial assessment and adoption. This suggests a potential £25 million GBP ($33.45 million USD) cost savings per year for the health system.
Demonstrated cost savings beginning in the first year, with benefits persisting in lifetime modeling.

“These data provide compelling real-world evidence underscoring the clinical value of lesion-specific Heartflow FFR_CT Analysis to provide precise, localized physiological assessments,” said Campbell Rogers, M.D., F.A.C.C., Chief Medical Officer at Heartflow. “We now see that lesion-specific FFR_CT insights can also help predict which patients are most likely to experience future events, enabling clinicians to tailor care earlier with greater precision and reduce costs.”

These analyses are the latest to demonstrate the prognostic power of the Heartflow One platform, the most accurate noninvasive AI-enabled CAD assessment technology, including RoadMap™ Analysis, FFR_CT Analysis and Plaque Analysis. Insights from FISH&CHIPS add to a growing body of evidence demonstrating the clinical and economic value of the Heartflow One platform providing superior patient outcomes in patients with confirmed CAD.³^,⁴ A retrospective analysis of symptomatic patients from a cohort of the FISH&CHIPS Study presented at the American Heart Association (AHA) Scientific Sessions 2025 provided strong validation of total plaque volume-based staging measured with Heartflow Plaque Analysis as a predictor of future heart attacks or cardiovascular death.⁵ Heartflow One provides an integrated workflow that empowers physicians to improve care by enabling a faster, more optimal diagnosis to avoid unnecessary tests.

About FISH&CHIPS

FISH&CHIPS, the largest FFR_CT study conducted to date, is a real-world, multicenter, quasi-experimental observational clinical study designed to assess the incremental impact of adding FFR_CT to a coronary CTA-first diagnostic paradigm for CAD at a national level. The study analyzed data from 27 NHS hospital sites in England, including 90,553 patients followed for at least two years. The primary objective was to determine whether introducing a coronary CTA+FFR_CT diagnostic pathway was clinically useful and safe compared to a standard-of-care diagnostic chest pain pathway using coronary CTA alone. Two-year data were published in May 2025 in Nature Medicine, showing improved care efficiency with a reduction in unnecessary invasive and noninvasive cardiac tests using coronary CTA and Heartflow FFR_CT versus coronary CTA alone. The study was funded by the UK Medical Research Council (MRC) and supported by the National Institute for Health and Care Research (NIHR) Research Delivery Network.

References

Bell et al. AHA 2025.
Fairbairn et al. EACVI 2025.
Madsen KT, et al. ADVANCE-DK 7-year. Presented at TCT Scientific Sessions 2024
Douglas PS, et al. The PRECISE Randomized Clinical Trial. JAMA Cardiol. 2023;8(10):904–914. doi:10.1001/jamacardio.2023.2595
Fairbairn et al. AHA 2025.