Giordano Botta: From the ‘Power of Zero’ to a Precise Understanding of Cardiovascular Risk
Giordano Botta, CEO and Co-Founder of Allelica, shared a post on LinkedIn about a recent article he and his colleagues co-authored, adding:
“For years, cardiology has referred to the ‘power of zero.’
A coronary artery calcium (CAC) score of 0 has been considered highly reassuring, often used to defer preventive therapies such as statins.
But this reassurance does not apply to everyone.
In a new preprint by our team at Allelica, Inc, we show that the concept of the power of zero is misleading for individuals with high polygenic risk for coronary artery disease (CAD).
Even in the absence of calcified plaque, individuals with high PRS have a risk of CAD that exceeds the thresholds used in guidelines to recommend statin therapy.
CAC equals 0 does not eliminate risk when PRS is high.
This finding highlights an important limitation of CAC scoring.
CAC measures calcified plaque, but atherosclerosis frequently begins as non-calcified soft plaque, which is not detected by CAC scans.
Imaging studies using serial coronary CT angiography (CCTA) have shown that individuals with high PRS tend to have a higher burden of non-calcified dangerous plaque and experience faster progression of these plaques over time.
This is where the future of imaging becomes interesting.
CCTA allows visualization of the full spectrum of atherosclerosis, including the soft plaques that CAC scans cannot detect.
In the context of precision prevention, combining genetic risk with advanced imaging will allow us to identify individuals who appear low risk today but are already on a trajectory toward a heart attack.
At Allelica, we believe the future of cardiovascular prevention will integrate:
- Inherited risk (polygenic risk score)
- Advanced imaging (coronary CT angiography)
- Clinical risk factors
Moving from the ‘power of zero’ to a precise understanding of cardiovascular risk.”
Title: Prediction of incident coronary artery disease in individuals with zero coronary artery calcium using a novel multi-ancestry, label-free polygenic risk score framework
Authors: Giordano Bottà, Muriel Rossi, Jen Kintzle, Paolo Di Domenico
Read the Full Article on MedRxiv
Stay updated with Hemostasis Today.
-
Apr 15, 2026, 13:25Wolfgang Miesbach: Platelet Variation and How Do They Move Over Time?
-
Apr 15, 2026, 12:44Marwa Elnahas: 4Ts Scoring Tool for Heparin – Induced Thrombocytopenia
-
Apr 15, 2026, 12:27Laurent Bertoletti: Joining Global Experts to Improve Thrombosis Care in Cancer for the ICTHIC 16th Edition
-
Apr 15, 2026, 12:13Francesco Antonio Veneziano: JCDD MDPI Calls for Papers on Advances in Thrombosis and Antithrombotic Therapy
-
Apr 15, 2026, 11:05Julius Kyei Baffour: Understanding Thrombophilia Testing and Patient Risk
-
Apr 15, 2026, 09:10Shall I Bleed Less with Age? Just 2 Weeks Until the Webinar – EHC
-
Apr 15, 2026, 08:51Moustafa Abdou: Sutimlimab is Transforming Outcomes in Cold Agglutinin Disease
-
Apr 15, 2026, 04:52Ulrich Pecks: Personalized Approaches to VTE Prevention in Pregnant Women with Inherited Thrombophilia
-
Apr 15, 2026, 04:06Brenda Pleasant: Insights from the HFA Symposium on Hemophilia Care