Maria Cherska: Should We Continue Relying on Risk Prediction or Shift to Direct Detection of Atherosclerosis?
Maria Cherska, The Head of Cardiology Department at The State Institution «V.P. Komisarenko Institute of Endocrinology and Metabolism», shared a post on LinkedIn:
“Beyond Risk Scores: Is It Time to See Atherosclerosis Rather Than Predict It?
One of the most thought-provoking sessions at EAS 2026 focused on the limitations of traditional cardiovascular risk calculators and the growing role of imaging in prevention.
Key messages:
- Risk calculators (SCORE2, SCORE2-OP and others) are valuable at the population level but may lack precision for individual patients.
- Imaging detects actual disease rather than estimating risk from surrogate markers.
- Tools such as:
- Coronary Artery Calcium Score (CACS)
- Carotid and iliofemoral ultrasound
- Coronary CT angiography (CCTA)
Retinal imaging
- can improve risk stratification beyond traditional risk scores and help identify patients who may benefit from more intensive prevention strategies.
However, imaging should be used thoughtfully in selected patient populations, and further evidence is needed regarding clinical utility and cost-effectiveness.
A key question for modern preventive cardiology:
Should we continue relying primarily on risk prediction, or should we increasingly focus on direct detection of atherosclerosis?”
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