How Dr. Jim Min Raised $300M to Prevent Heart Attacks

Heart disease kills more people than all cancers combined — and most victims get no warning. Dr. Jim Min spent 15 years studying silent plaque buildup in coronary arteries before co-founding Cleerly to automate that detection with AI. His story is a blueprint for building in regulated markets where lives, not metrics, are on the line.

Key Facts

• Heart disease vs. cancer deaths: Cardiovascular disease causes 40% more deaths than all cancers combined (Dr. Jim Min)
• Heart attack frequency: Someone suffers a heart attack every 40 seconds in the US (Dr. Jim Min)
• Average age of sudden coronary death: Approximately 50 years old in the US (Dr. Jim Min)
• Preventability: 90% of heart attacks are preventable with early identification (Dr. Jim Min)
• Series C raise: $225M led by Fidelity and T. Rowe Price to fund a 7,500-patient randomized control trial (Dr. Jim Min)

Why Heart Disease Is Still the Silent Killer No One Talks About

Most heart attacks happen with zero warning. Over 50% of cases are completely asymptomatic before a catastrophic event. The average age of sudden coronary death in the US is around 50 — far younger than most people assume — and 90% of those deaths are preventable with early detection.

Heart disease doesn't announce itself. Unlike cancer or diabetes, coronary artery disease often stays invisible until it's too late. Dr. Min sees this pattern constantly: patients who exercised regularly, ate well, and had no obvious risk factors — then died at home with no warning.

The statistics are stark. According to Dr. Min, cardiovascular disease causes 40% more deaths than all cancers combined, and someone in the US suffers a heart attack every 40 seconds. Yet most diagnostic tools only catch disease once patients feel symptoms — the lucky ones, as Dr. Min calls them.

The real problem is that the most common presentation of heart disease isn't chest pain. It's a fatal event. 'The most common diagnosis is suffering a catastrophic event,' Dr. Min explained. 'Those are the people who go out for a run and never come back, or who go to sleep and never wake up.'

"The most common presentation for having heart disease is not presenting with chest pain or shortness of breath but it's simply having a catastrophic event — dying of a heart attack or suffering a heart attack at home with no antecedent warning." — Dr. Jim Min

"90% of heart attacks are preventable. It's not that we lack the treatments. It's that we're just not identifying people soon enough." — Dr. Jim Min

How AI and CT Imaging Detect Dangerous Plaque Before Symptoms Strike

Cleerly applies AI to coronary CT angiograms — fast, non-invasive scans — to identify and characterize plaque in artery walls. Not all plaque is equal: some types predict heart attacks, others don't. Cleerly's platform quantifies the difference, turning 10 hours of manual analysis into automated, actionable clinical insight.

The key insight behind Cleerly is that plaque is the single integrating metric for all heart disease risk. Dr. Min describes it as 'the integrated summation of everything that person experienced over the course of their lifetime' — capturing known and unknown risk factors in one measurable signal.

What makes Cleerly's approach different is plaque characterization, not just detection. Clinical trials revealed that some plaques are extremely dangerous predictors of heart attacks, while others are stable and almost protective. More importantly, the dangerous ones can be transformed into stable ones through targeted treatment — and that transformation is trackable.

The imaging technology is a coronary CT angiogram: a 3D X-ray using contrast dye, completed in 10-15 minutes, with radiation exposure lower than background levels in New York City. What was impossible to scale — 10 hours of manual technologist work per patient — Cleerly automated using deep learning trained on years of clinical trial data.

"The plaque that is building up silently within the walls of the artery — that is the integrated summation of everything that that person experienced over the course of their lifetime." — Dr. Jim Min

"The medicines didn't make plaque go away per se. They just transformed that plaque from the bad to the good plaque over time. And that was the mechanism of stabilization." — Dr. Jim Min

• Coronary CT angiogram: 10-15 min, non-invasive, ~1 millisievert radiation
• AI replaces 8-10 hours of manual image tracing per patient
• Platform translates imaging data into plain-language reports for all stakeholders
• Validated against invasive catheter tests including intravascular ultrasound and optical coherence tomography

The 10-15 Year Roadmap: FDA, CPT Codes, and Payer Coverage in Healthtech

Building a medtech product means clearing at least five sequential hurdles: product development, FDA clearance, CPT code acquisition, payer coverage, and clinical adoption. Each step takes years. Dr. Min describes this as a realistic 10-15 year journey — the cost of changing medicine in a system built to resist change.

Dr. Min lays out the healthtech gauntlet with brutal clarity. After building the product and getting FDA clearance, founders still can't generate meaningful revenue. They need a CPT code from the American Medical Association, then a corpus of clinical evidence proving accuracy, prognostic value, management change, and cost effectiveness — then coverage negotiations with over 1,100 individual payers.

Coverage and reimbursement are not the same thing. 'You can be covered but not reimbursed. Conversely, you can be reimbursed but not covered,' Dr. Min noted. Getting both requires navigating public payers like Medicare and Medicaid alongside private insurers like Aetna, United, and Cigna — each with its own process.

Even after all of that, there's a final layer: clinical community adoption. Guidelines take years to update. Fellowship-trained physicians tend to practice the way they were trained. 'Things take about 20 years to change medicine,' Dr. Min said — roughly the time for one physician generation to retire and another to emerge.

"There's 1,100 payers in the country. So then you've got to go talk to them each one by one." — Dr. Jim Min

"The product market fit of virality of just building MVP, shipping product — in healthcare, it's harder to do than ad-tech or something like that." — Dr. Jim Min

How Cleerly Raised $300M — and Survived 17 Days from Zero

Cleerly raised an $8.5M Series A from high-net-worth individuals for product development, a Series B from medtech venture firms to pursue CPT codes and symptomatic-patient revenue, and a $225M Series C from Fidelity and T. Rowe Price to fund a 7,500-patient screening trial. In between, they nearly ran out of money during COVID.

Cleerly's funding story mirrors its product journey: long, high-stakes, and non-linear. The Series A was essentially a friends-and-family round of $8.5M, used purely for product development and early FDA work. After a COVID-era extension round, they emerged with cleared products and began targeting symptomatic patients — the addressable market of 15-20 million Americans presenting annually with chest pain or shortness of breath.

Revenue started through concierge and longevity-focused patients paying out of pocket. 'I didn't make a company so that people would have to pay cash,' Dr. Min said. 'I wanted it to be standard of care and covered by insurance.' That required years of market access work to secure CPT codes and coverage policies.

The Series C — $225M from Fidelity and T. Rowe Price — funds Cleerly's North Star: a large randomized control trial to prove that universal screening of asymptomatic people reduces heart attacks. The trial targets over 100 million eligible Americans. Between Series A and Series C, the company hit a 17-day runway during the pandemic, saved by supportive backers and a refusal to let the mission die.

"During the pandemic, we were 17 days away from being out of operating capital. That was a dark month." — Dr. Jim Min

"We've done a blended, compounded annual growth of about a little over 100% over the last five years. And we've probably done close to 100,000 patients at this point." — Dr. Jim Min

Founder Advice: Embrace Failure, Stay Mission-Driven, and Live in the Jungle

Dr. Min's core advice for founders: expect failure, normalize it, and use mission as fuel. Most founders are overachievers who've rarely failed — that makes dark days more destabilizing. Building a mindset around failure in advance transforms it from a threat into a signal. Mission alignment keeps 200-person teams moving through the hardest moments.

Dr. Min doesn't sugarcoat the founder experience. He references a Samuel Johnson quote — 'ever tried, ever failed, no worries, fail again, fail better' — as the operating philosophy for anyone building a company. His own journey included ML algorithms that stopped working eight months in, a 17-day runway crisis, and years of navigating regulatory bodies that move on their own timeline.

What pulled Cleerly through the hard moments wasn't just resilience — it was mission clarity. 'I am surrounded by 200 people who are mission driven,' Dr. Min said. 'And that motivates me like you cannot believe.' Every new story of a preventable death reinforces why the work matters.

He also shared a metaphor from a key donor that captures the startup mentality: the jungle. You can stay on the safe edge — calm, predictable — or go in where you fight every day. The jungle is harder, but for those wired for it, it's the only place that feels right.

"In business, you will fail. If you can get your mindset around that, that you will experience failure, you're going to experience some very dark days. Then all of a sudden they become easier to take." — Dr. Jim Min

"There's a jungle there and you can either be out on the outside of the jungle where it's pretty calm and nice, or you can be in the jungle and you're going to be fighting every day and trying not to get killed. For whatever reason, I just like being in the jungle." — Dr. Jim Min