Timely identification and treatment of patients with coronary artery disease (CAD) is essential to reduce cardiovascular events, yet traditional chest pain pathways may under-treat individuals with subclinical risk. At the European Society of Cardiology (ESC) 2025 Congress, data was collected from five NHS hospitals testing a revised chest pain pathway incorporating an artificial intelligence–derived coronary inflammation and cardiovascular risk score.

In a single-center analysis of 135 patients referred to a Rapid Access Chest Pain Clinic, the standard pathway based on nurse assessment and coronary CT angiography (CCTA) was compared with the AI-enhanced pathway. The AI-based approach recommended initiation or intensification of cardiovascular preventive therapy, including statins, ezetimibe, antiplatelets, and colchicine, in 84% of patients compared with 30% in the standard pathway (p<0.01).

Notably, patients with no or mild CAD received significantly more preventive therapy under the AI-guided pathway (87% vs 25%). High perivascular fat attenuation index and elevated AI-derived risk scores correlated with higher rates of therapy initiation. These results suggest that incorporating AI-driven coronary risk assessment can improve personalized preventive care and may reduce future cardiovascular events.