Heartflow Raises 2026 Revenue Outlook to $262–264 Million After 57% Quarterly Growth
Key Facts
Heartflow reported on November 12 results for the third quarter ended September 30, with revenue of $72.9 million, up 57% year over year, and raised its 2026 revenue outlook to $262–264 million. The new range implies expected annual growth of 49% to 50%, compared with a previous outlook of 40% to 42% on revenue of $246–250 million. Chief Executive John Farquhar said revenue accelerated for the third consecutive quarter and U.S. revenue posted its fastest growth in 11 quarters. The company also raised its adjusted gross margin outlook to about 82.5% from about 82% previously. The revisions put strong U.S. quarterly growth and broader use of the company’s products at the forefront of the reasons for the higher annual outlook.
U.S. revenue was $67.9 million, up 60% from the year-earlier period, while international and other revenue rose 29% to $4.9 million, according to results data cited by Investing.com. The company attributed the increase in global revenue mainly to higher case volumes tied to FFRCT revenue and plaque analysis in the United States. Farquhar said plaque analysis activation was progressing faster than planned and its use was expanding across a broader range of suitable CCTA scans. That reinforces the U.S. market’s role in the company’s growth, as its revenue growth rate clearly outpaced international and other revenue during the quarter. In the second quarter, revenue was $64.1 million, up 48% year over year, meaning the third quarter delivered higher revenue and a faster annual growth rate.
Gross margin improved to 83.6% in the third quarter from 76.5% a year earlier, while adjusted gross margin was 83.8%, compared with 76.8% in the year-earlier period. The company attributed the margin expansion mainly to higher case volumes and improved production-team productivity resulting from AI efficiency initiatives. Gross margin in the second quarter was 83.0%, compared with 75.5% in the second quarter of the prior year. Operating loss narrowed to $13.8 million from $15.1 million a year earlier, while adjusted operating loss contracted to $5 million from $11.1 million. The figures show improvements in operating profitability and margin, despite continued net losses.
Net loss was $11.5 million, or $0.13 a share, compared with $50.9 million, or $1.04 a share, in the third quarter of 2025. The year-earlier period’s loss included noncash items and a debt repayment-related loss, the company said. Investing.com reported adjusted loss per share of $0.03, compared with the analyst consensus estimate of $0.17. Still, HTFL shares fell 5% after the results were announced on November 12, according to the same report. Cash, cash equivalents and investments totaled $253 million on September 30, the company’s reported liquidity balance at quarter-end.
The quarterly results come amid a market that the company said in its second-quarter report was growing rapidly, but where CCTA technology used to detect coronary artery disease remained underpenetrated. Farquhar described FFRCT activity at the time as strong and sustained, and said plaque analysis was emerging as a second growth driver. On November 2, the company announced results from the DECIDE assessment of more than 6,000 patients with similar characteristics, saying plaque analysis was associated with a 34% reduction in major adverse cardiovascular events and half the rate of myocardial infarction after one year, compared with CCTA alone. It also said medical management changed for more than half of patients within 90 days, and 50% reached the LDL-C goal compared with 35% with CCTA alone, with the result sustained through one year. The company presented these findings as clinical context for product expansion, alongside its announcement of increased commercial use.
The third-quarter earnings call was scheduled for the day of the announcement, November 12, at 1:30 p.m. Pacific time, or 4:30 p.m. Eastern time, according to Heartflow investor relations. The call followed the release of the quarterly results and the updated annual revenue and adjusted margin outlook. In its statement, the company linked the raised outlook to the performance of its diagnostic platform and disciplined execution of commercial, innovation and clinical initiatives. It also said plaque analysis activation was ahead of plan and its use was expanding. U.S. market performance, which management described as the fastest-growing in 11 quarters, remains central to the company’s account of its results and outlook.