The Future of Cardiology: The End of the Coronary Artery Calcium Score; Using Artificial Intelligence Phenotyping of Coronary Arteries to get a Reversible Plaque Score

George Shapiro, M.D.

Chief Medical Innovation Officer, Fountain Life; Adjunct Assistant Professor Clinical Medicine, New York Medical College, Valhalla, NY; Founding Partner, Cenegenics, New York City; Member, AMMG Conference Planning Committee

Current cardiovascular diagnostic approaches fail to identify patients at risk of heart attack. Symptom-driven evaluation assesses surrogates of dis-ease rather than the disease itself. The evaluation of coronary artery disease is the same as it was 50 years ago; and this approach does not reduce heart attacks. Discrimination of heart attack risk is from the type of plaque. I will reveal a new approach using artificial intelligence phenotyping as the most effective way to providing risk-guided care. Phenotype unifies and integrates the influence of all risk factors over a person’s life. Plaques that look differently behave differently. High risk plaques cause heart attacks, progress rapidly, have a poor response to medical therapy and cause ischemia. Low risk plaques do not cause heart attacks, progress slowly and are non-ischemic. Newer medical therapy treatments will also be dis-cussed for primary prevention that result in the transformation of high-risk into low-risk plaques thus stabilizing plaques reducing major adverse cardiac events.