Page 80 - Forbes - Asia (September 2018)
P. 80
Technology
Breaking Hearts
HeartFlow has raised $467 million for a test to detect heart disease.
Problem: It might not make patients better o .
BY ELLIE KINCAID
J ohn Stevens’ corner oice in Redwood City, California, wings of ighter jets. Could the same mathematics explain blood
has a nice view of the San Francisco-Oakland Bay Bridge.
moving through the heart? He hooked up with Christopher Za-
rins, the chief of vascular surgery at Stanford’s School of Med-
His desk, though, is a hand-me-down, and the cracked
leather upholstery on the chairs reveals their history as icine, earning a Ph.D. for the cardiology work and becoming
Ikea oor models. “We can probably aford some new chairs a professor at Stanford himself. Together, they founded Heart-
now,” he says. Flow in 2007.
You’d think. HeartFlow, the health-tech startup of which Taylor, HeartFlow’s chief technology oicer, did a study of his
Stevens is chief executive and president, has raised $467 mil- early sotware on a dozen patients in Latvia and raised $2 million
lion, most recently at a $1.5 billion valuation, from inves- in venture capital. Stevens had been inspired to become a sur-
tors such as Wellington Management, Baillie Giford & Co., geon as a boy, ater a pitchfork went through his toe, but quit his
GE Ventures and BlueCross BlueShield Ventures, according to job doing heart operations for the startup life two decades ago.
Pitchbook. He joined Taylor in 2010.
he valuation is based on a big idea: a noninvasive test that In a 2014 study, HeartFlow’s sotware analyzed the CT
peers into a patient’s coronary arteries to see how blocked they scans of 254 patients, matching FFR 84% of the time in detect-
are. Right now, such a test involves threading a catheter from ing a clog and 86% when blood was owing freely. Later that
the groin up to the heart and measuring blood ow, a slight- year the FDA approved HeartFlow’s sotware as a medical de-
ly risky procedure called fractional ow reserve (FFR) that is vice to evaluate the symptoms of coronary artery disease.
done a million times a year worldwide to decide whether a pa- Experts use the HeartFlow test mainly in ambiguous cases.
tient needs a stent to open a clogged artery. Using sotware Hank Plain, 60, a healthcare investor who focuses on medi-
trained with a deep-learning algorithm, HeartFlow says it can cal devices, got a CT scan that showed calciied plaque in his
get a similar measurement from a CT scan, a lower-risk, three- coronary arteries, but a stress test (a walk on a treadmill with
dimensional picture of the heart constructed with X-rays. electrodes on his chest) indicated no problems. hen a CT
Medicare reimburses HeartFlow $1,450 per test. scan was put through HeartFlow’s sotware, which revealed
“his will be the most efective way of looking at cardiovas- two partial block ages. His doctor decided to insert two stents.
cular disease and safer than anything else on the market,” says “It’s very scary to know you have coronary artery disease,
Bill Weldon, HeartFlow’s chairman and the former chief exec- knowing it played out with other family members,” Plain says.
utive of Johnson & Johnson. “And when you put those togeth- “It’s good to be back, focused on life.”
er, it’s a combination you can’t beat.” He sees the test being used An open question is when stents are worth their cost and
routinely. risk. hey save lives when placed during a heart attack and ease
Skeptics are legion. “Over time, these kinds of technologies chest pain. But a 2,287-patient study a decade ago and a more
get hyped, and when they get studied, reality sets in,” says Ste- recent comparison to a sham procedure raised doubts that they
ven Nissen, the chairman of cardiology at the Cleveland Clinic. are better than medication. So does using HeartFlow prevent
“Someone takes an idea that seems very sexy and attractive, but unnecessary procedures or cause them?
when you get down to the science, it isn’t solid.” For every $1,450 test, HeartFlow says, it prevents $4,000 in
he technology’s usefulness may come down to a deeper costs. But “do patients live longer and have fewer heart attacks
question: How efective are stents for treating heart disease, and when you do this approach, as opposed to something more
do you even need to know whether an artery is open or not? routine?,” asks Venkatesh Murthy, a cardiologist at the Univer-
HeartFlow was started by Charles Taylor, who as a Ph.D. sity of Michigan. Indeed, do patients need a cardiac ow mea-
student in the 1990s was studying how wind coursed over the surement at all?
78 | FORBES ASIA SEPTEMBER 2018
