# Cardiovascular Risk Prediction

Coronary inflammation could previously be measured only on contrast-enhanced coronary CT angiography, while routine calcium scoring uses low-dose noncontrast CT. A deep-learning pipeline trained and externally validated in a multicenter cohort computes a pericoronary fat attenuation index (FAI) score from noncontrast CT; the score performed comparably to the contrast-based FAI and further separated cardiovascular death and major adverse cardiovascular events among people with a calcium score of zero.

Coronary inflammation could previously be measured only on contrast-enhanced coronary CT angiography, while routine calcium scoring uses low-dose noncontrast CT. A deep-learning pipeline trained and externally validated in a multicenter cohort computes a pericoronary fat attenuation index (FAI) score from noncontrast CT; the score performed comparably to the contrast-based FAI and further separated cardiovascular death and major adverse cardiovascular events among people with a calcium score of zero.

This study developed CARDIAC-FM, a multimodal foundation model that integrates 12-lead ECG and cardiac MRI through self-supervised representation learning and cross-modal contrastive alignment, pretrained on 57,609 paired samples from UK Biobank, improving prediction of incident atrial fibrillation and heart failure, generalizing zero-shot to the Cardiovascular Health Study and the Multi-Ethnic Study of Atherosclerosis, and transferring to cardiac MRI phenotype prediction, time-to-event modelling, and additional outcomes including myocardial infarction, ischaemic stroke, cardiovascular death, and all-cause mortality.

This study developed CARDIAC-FM, a multimodal foundation model that integrates 12-lead ECG and cardiac MRI through self-supervised representation learning and cross-modal contrastive alignment, pretrained on 57,609 paired samples from UK Biobank, improving prediction of incident atrial fibrillation and heart failure, generalizing zero-shot to the Cardiovascular Health Study and the Multi-Ethnic Study of Atherosclerosis, and transferring to cardiac MRI phenotype prediction, time-to-event modelling, and additional outcomes including myocardial infarction, ischaemic stroke, cardiovascular death, and all-cause mortality.