AI-Assisted Heart Screening: Coronary CT Angiography (CCTA) in Seattle
Part of the Kosmos proactive care model
Coronary heart disease often progresses for decades without symptoms, and traditional risk calculators miss roughly half of patients who go on to have a heart attack. Coronary CT angiography (CCTA) with AI analysis directly visualizes the coronary arteries, identifying soft plaque, calcified plaque, and narrowings years before they cause symptoms. Combined with advanced lipid markers like Lp(a) and ApoB, it gives us a real picture of cardiovascular risk, not an estimate.
Why this matters
Heart disease is the leading cause of death, and its first symptom is too often the heart attack itself. The standard tools miss a lot. Risk calculators built on age, cholesterol, and blood pressure place many people who go on to have events in the low-risk bucket. A stress test only flags arteries that are already significantly narrowed, which means it can read normal during the decades when disease is quietly building.
Coronary CT angiography looks directly at the arteries. With AI analysis, it characterizes plaque, including the soft, inflamed kind that does not show up on a calcium score but is the most likely to rupture. That is a different question than how much hardened calcium has accumulated over a lifetime; it is a look at what is actually there right now.
Advanced lipids explain why. Lp(a) is largely genetic, rarely measured, and a meaningful driver of risk in the people who carry it. ApoB counts the particles that actually lodge in artery walls. Together they often reframe a risk picture that a standard cholesterol panel called normal.
What Kosmos does in this focus area
What we measure and track
- Coronary CT angiography (CCTA) with AI plaque analysis
- Advanced lipid markers: Lp(a), ApoB, hsCRP, ESR
- Routine screenings as indicated: abdominal aortic aneurysm, carotid artery stenosis
- Coordination with cardiology when a finding warrants specialist input
What we look for
On a CCTA we look at total plaque burden, the type of plaque, and whether any narrowing is significant. A clean scan is strong reassurance and shapes how aggressively we screen going forward. Soft or mixed plaque, even without a major narrowing, changes the plan: it usually means earlier and firmer treatment of the things that drive progression, cholesterol particles, blood pressure, blood sugar, and inflammation, rather than waiting for a single number to cross a guideline threshold.
Lp(a) and ApoB sharpen those decisions. An elevated ApoB tells us the standard cholesterol numbers are understating risk and that we should treat to particle count, not just LDL. A high Lp(a) raises the whole baseline and lowers our threshold for acting. When a finding warrants it, we bring in cardiology and stay involved in the plan.
Who this is most relevant for
- Adults 40+ with any family history of heart disease
- Members whose lipid panels look fine but who feel something is off
- Anyone whose 10-year risk calculator score does not match the family history
- Members in their 50s and 60s wanting concrete answers, not estimates
FAQ
Common questions.
- A calcium score measures only calcified (older) plaque. CCTA with AI sees both calcified plaque and soft (newer, more dangerous) plaque, and it actually visualizes the coronary arteries themselves. Calcium scoring is a screening test; CCTA is a diagnostic one.
- Modern CCTA delivers a fraction of the radiation it did even five years ago, often less than a mammogram. We use the test once annually for Optimal Care members and reserve it for situations where the information genuinely changes care.
- Often, yes. The common pattern is a person with normal cholesterol and a reassuring risk score whose scan shows real plaque already forming. That finding moves them from watchful reassurance to a concrete prevention plan years earlier than any other test would have, which is exactly the window where treatment does the most good. The reverse happens too: a genuinely clean scan can safely take the pressure off and refocus the plan on other priorities.
Speak with our physicians for 30 minutes.
An unhurried conversation about your health and how Kosmos can help. No obligation, no pressure.