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AI Analysis of Mammograms Predicts Cardiovascular Disease Risk in Women

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AI Revolutionizes Heart Disease Risk Prediction in Women via Mammograms

New research, published on March 9, 2026, in the European Heart Journal, indicates that artificial intelligence (AI) can analyze standard X-ray mammograms to predict a woman's risk of developing serious or fatal heart disease. This innovative technique assesses calcium deposits in breast arteries, a recognized indicator of arterial hardening. It may significantly help identify women with undiagnosed or untreated cardiovascular disease by leveraging an existing breast cancer screening platform.

Research Overview

The study, led by Dr. Hari Trivedi of Emory University, Atlanta, USA, addresses a critical health disparity. Researchers highlighted that heart disease remains the primary cause of death in women globally, noting that women are often underdiagnosed and undertreated for cardiovascular conditions compared to men.

Mammograms, routinely performed for breast cancer screening, can also reveal calcium deposits in breast arteries, which are associated with heart disease. The research aimed to determine if AI could leverage this information to identify women at risk of cardiovascular disease without additional cost or inconvenience.

Study Methodology

The comprehensive study involved 123,762 women, aged 40 to 79, who had undergone breast screening at two major U.S. health systems and had no prior known cardiovascular disease. An AI system was employed to analyze the extent of calcium deposits in breast artery tissue, known as breast arterial calcification (BAC), by measuring the area of BAC in square millimeters.

Participants were categorized into four groups based on their BAC levels:

  • No BAC
  • Mild BAC (0–10 mm²)
  • Moderate BAC (10–25 mm²)
  • Severe BAC (over 25 mm²)

The women were followed for approximately seven years to monitor for major adverse cardiovascular events (MACE), which included acute myocardial infarction (heart attack), stroke, heart failure, and all-cause death. Arterial calcification is widely recognized as an indicator of arterial hardening and a higher risk of severe cardiovascular conditions.

Key Findings

The study found a direct and significant correlation between increased breast arterial calcification and a higher risk of serious cardiovascular events.

Compared to women with no BAC:

  • Those with mild calcification had an approximately 30% increased likelihood of developing serious cardiovascular disease.
  • Women with moderate calcification experienced an increased risk ranging from over 70% to approximately 80%.
  • Participants with severe calcification had a two to three times higher risk of a major heart or circulation event.

Crucially, these associations were observed even in women under 50 years old and remained significant after adjusting for other risk factors, including diabetes, smoking, and the PREVENT score, a standard tool for heart disease risk assessment. This highlights BAC as an independent risk indicator.

Implications and Future Steps

Dr. Trivedi suggested that existing mammograms could offer important insights into heart health for women, potentially initiating discussions with doctors about preventive measures such as cholesterol testing or medication. For clinicians, this presents a practical method to identify women at cardiovascular risk who might otherwise be overlooked, especially as BAC in younger women can indicate elevated risk that age-weighted models might miss.

Policymakers could potentially integrate this AI technology into current mammography programs, reaching millions of women annually without requiring additional infrastructure. The necessary next steps include integrating the AI tool into imaging workflows and developing clear guidelines for patient and doctor notification. A clinical trial is reportedly being planned to test these implementation procedures.

Expert Perspective

In an accompanying editorial, Professor Lori B. Daniels from the University of California, San Diego, USA, highlighted the disparity in health screening rates. She noted high mammography rates among women aged 45 and older in the USA (nearly 70%) and women aged 50-69 in the European Union (two-thirds reporting a mammogram within two years), contrasted with less than 40% reporting knowledge of their cholesterol levels.

"Breast arterial calcification (BAC) has the potential to address this disparity by utilizing an established cancer screening platform to identify cardiovascular risk in women who might not otherwise engage with prevention strategies."

Professor Daniels further emphasized that the study provides robust evidence that AI-quantified BAC is an independent indicator of cardiovascular risk and mortality, strongly supporting its implementation to enhance prevention efforts for heart disease.