Akinchan Bhardwaj: Will Plaque Imaging Eventually Reshape Preventive Cardiology Workflows?
Akinchan Bhardwaj, Consultant Interventional Cardiologist at Kauvery Hospital, shared a post on LinkedIn:
“For 50 years, cardiology has estimated risk.
Now we can actually ‘see’ disease.
Traditional risk scores, Framingham, ASCVD estimate the probability of coronary disease.
But they don’t show the artery.
Coronary CT angiography (CCTA) changes that.
In addition to measuring calcium, It reveals:
- total plaque burden
- plaque composition
- high-risk features
- early non-calcified disease
Studies like SCOT-HEART and large registries such as CONFIRM suggest that visualizing plaque can change management and potentially outcomes.
This raises an uncomfortable question for prevention:
If we can directly see coronary atherosclerosis, how long will probability-based risk models remain the center of decision-making?
Risk scores estimate likelihood. Imaging reveals biology.
The future of preventive cardiology may lie in combining both genetics, biomarkers, AI and direct plaque visualization to identify disease before events occur.
Prevention has always been about acting earlier and CCTA may allow us to act earlier with evidence, not estimates.
Will plaque imaging eventually reshape preventive cardiology workflows?
Curious how experts view this, Dr. Pradeep Natarajan if you have thoughts on where plaque imaging fits into preventive workflows.”

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