Heartflow (NASDAQ:HTFL) raised its 2026 revenue forecast after reporting third-quarter sales growth of 57%, citing wider adoption of its Plaque Analysis product, durable demand for FFRct and growth in coronary CT angiography.
The company reported revenue of $72.9 million for the quarter ended Sept. 30, up from a year earlier. U.S. revenue increased 60% to $67.9 million, including $11.8 million from Plaque Analysis. Global revenue cases rose 89.5% to 98,155.
“For the third consecutive quarter, our year-over-year revenue growth accelerated, and we finished ahead of our expectations,” President and CEO John Farquhar said on the earnings call.
Higher Guidance and Improving Margins
Heartflow now expects 2026 revenue of $262 million to $264 million, representing growth of 49% to 50%. The midpoint is $15 million above its previous forecast of $246 million to $250 million. The company also raised its Plaque Analysis revenue outlook to $36 million to $37 million.
The company lifted its full-year non-GAAP gross margin forecast to approximately 82.5%. Third-quarter non-GAAP gross margin was 83.8%, compared with 76.8% a year earlier, reflecting higher volumes, a greater contribution from Plaque Analysis and AI-enabled production efficiencies, Chief Financial Officer Vikram Verghese said.
Non-GAAP operating loss narrowed to $5 million from $11.1 million a year earlier. Non-GAAP net loss was $2.7 million, or 3 cents per share, compared with $13.2 million, or 27 cents per share. On a GAAP basis, Heartflow reported a net loss of $11.5 million, or 13 cents per share. It ended the quarter with $253 million in cash, equivalents and investments.
Verghese said the company has increased confidence in reaching cash flow profitability by mid-2028. He also expects operating expenses as a percentage of revenue to decline in 2027 and operating losses to narrow, while Heartflow continues to invest in research, clinical trials and sales.
Product Adoption and Pricing
Heartflow expects approximately 1,300 Plaque Analysis-activated accounts by year-end, compared with close to 500 at the start of 2026. Farquhar said the product is covered for about 82% of U.S. lives, up from 78% in the prior quarter.
Farquhar said physicians are increasingly using Plaque Analysis beyond patients also eligible for FFRct. Verghese said Plaque Analysis is applicable to approximately 60% of coronary CT angiography scans, compared with roughly one-third for FFRct. Farquhar cautioned that he expects steady utilization gains rather than a sudden surge.
The company also expects new account activations in 2026 to exceed the 340 added in 2025. New accounts generally take about a year to reach near-full FFRct utilization, Verghese said.
For the fourth quarter, Heartflow’s guidance implies nearly 37% year-over-year FFRct volume growth, according to Verghese. He said Plaque Analysis pricing is expected to be roughly flat sequentially, with most 2026 contractual increases already in effect. Another price step-up is expected in the first quarter of 2027; Verghese said anticipated pricing was a little more than 10% above the consensus estimate at the time of the call.
Clinical Data and Expansion Plans
Farquhar highlighted one-year results from a propensity-matched analysis of more than 6,000 patients in the prospective DECIDE registry. He said patients managed with Plaque Analysis had 34% fewer major cardiovascular disease events and half the heart attack rate of those managed with coronary CT angiography alone. The analysis also found that 50% reached their target LDL cholesterol level by 90 days, compared with 35% in the comparison group.
At the TCT conference, results from the randomized P4 study showed CT-guided PCI planning enabled by Heartflow matched intravascular ultrasound-guided planning on the study’s primary endpoint of one-year target vessel failure, Farquhar said. He added that median procedure time was 27% shorter with CT guidance.
Heartflow plans a broader rollout of its PCI Navigator planning product in 2027 and announced a collaboration with Boston Scientific to advance CT-guided PCI planning. Farquhar said interest from interventional cardiologists following the P4 presentation was high, although it was too early to know the ultimate impact.
The company is also pursuing use of Plaque Analysis in high-risk patients without symptoms. Two trials, REFINE-CAC and REWRITE-CAD, are expected to begin enrolling in the fourth quarter of 2026, while Evolve Plaque, a study with Amgen, is expected to begin in the first quarter of 2027. Farquhar said Heartflow expects to begin reporting data by the end of 2028 and enter those markets before the end of the decade.
About Heartflow (NASDAQ:HTFL)
HeartFlow, Inc. is a medical technology company that develops noninvasive tools to help clinicians assess coronary artery disease. Its platform analyzes coronary CT angiography scans to create personalized models of a patient’s coronary arteries and provide information that can support diagnosis and treatment planning. The company’s offerings include HeartFlow FFR CT Analysis, which estimates blood flow and the effects of artery narrowing, and tools for assessing coronary plaque. The technology combines medical imaging with computational analysis and artificial intelligence, giving clinicians information without requiring an invasive procedure to measure blood flow.
