Heart disease is the number one cause of death around the world. One of the keys to preventing it is being able to spot people who are at risk—especially those who may not show any symptoms yet.
A new study shows that the PREVENT risk calculator, a tool launched by the American Heart Association in 2023, can help identify people with hidden plaque buildup in their heart arteries and also predict their risk of future heart attacks.
This study was published in the Journal of the American Heart Association and was led by Dr. Morgan Grams at NYU Grossman School of Medicine. The researchers used electronic health records from nearly 7,000 adults who had undergone a special type of heart imaging test called coronary computed tomography angiography (CCTA) between 2010 and 2024.
This test produces a coronary artery calcium (CAC) score, which shows how much calcium is built up in the arteries—a sign of heart disease.
The PREVENT tool estimates a person’s 10-year and 30-year risk of having a heart attack, stroke, or heart failure. It uses details like age, blood pressure, cholesterol, body mass index (BMI), diabetes, kidney function, smoking, and social factors to create a risk score.
The new study checked whether people’s PREVENT scores matched their calcium scores and whether these tools could accurately predict future heart attacks.
Here’s what the study found: nearly 44% of participants had a low heart attack risk based on PREVENT. About 16% had mildly elevated risk, 34% had moderate risk, and just over 6% had a high risk. In general, higher PREVENT scores matched higher CAC scores, meaning those at higher predicted risk also had more plaque in their arteries.
When researchers combined the PREVENT risk score with the CAC score, they found that they could more accurately identify which people had a heart attack later. There were 485 heart attacks during an average follow-up time of just over one year. The group that had both a high PREVENT score and a high CAC score lined up well with the group that later had heart attacks.
The findings suggest that PREVENT can detect “subclinical” heart disease—meaning blocked arteries that haven’t yet caused symptoms. This is important because people may appear healthy but still have dangerous plaque building up inside their arteries.
Knowing this can help doctors decide who needs treatment, like cholesterol-lowering medications, to prevent a heart attack.
Dr. Sadiya Khan, a co-author of the study, explained that CAC scores from CT scans can be especially helpful when patients are unsure about starting or continuing treatment. Using CAC alongside the PREVENT tool may give patients and doctors more confidence in deciding on the best care plan.
The study had some limitations. It only looked at patients from one health system, and most were white adults, so the findings may not apply to all populations. Also, only patients who were already referred for CCTA were included, so they might have already had higher risk than the general public.
The study didn’t include non-calcified plaque, which can also be harmful but doesn’t show up in calcium scores. Finally, the follow-up period was short, averaging just 1.2 years.
Still, this study supports the use of both PREVENT scores and CAC scores together to better understand heart health, catch silent disease earlier, and offer treatments that could save lives. It also shows the power of combining new tools with existing tests to help patients and doctors make smarter, more informed choices about preventing heart attacks.
If you care about heart health, please read studies about top foods to love for a stronger heart, and why oranges may help fight obesity, diabetes, and heart disease.
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