A new study from Mount Sinai has found that many people who suffer heart attacks would not have been warned by current screening tools.
Nearly half of those who later had a heart attack would not have been flagged as high risk just two days before the event. This shows that the current methods used to prevent heart disease are missing a lot of people who are actually in danger.
Doctors often use two main tools to decide who needs treatment: the ASCVD risk score and a newer system called PREVENT. These tools help doctors guess a person’s chance of having a heart attack or stroke within the next 10 years.
They use things like age, blood pressure, cholesterol, diabetes, smoking, and other health details to calculate the risk. People who have a high score are usually given medicines like statins to lower their risk. If the score is low and the person has no symptoms like chest pain or trouble breathing, they’re often told they’re fine.
But the Mount Sinai researchers found big problems with this system. They looked at 474 people under the age of 66 who had their first heart attack between 2020 and 2025. None of them had a known history of heart disease.
The researchers collected health data and worked out what their ASCVD and PREVENT scores would have been two days before their heart attack. They found that 45% of the patients would not have been advised to get treatment or further testing using the ASCVD score. Even worse, 61% would not have been flagged by the PREVENT tool.
This means that many people who were in real danger would have been told they were low risk. On top of that, most patients didn’t feel any symptoms until it was too late. About 60% of them only started noticing symptoms less than two days before their heart attack. That means the disease had already reached a dangerous stage without any warning signs.
The study shows that relying only on risk scores and symptoms is not enough. These methods are based on data from large groups, but they don’t work well for spotting risk in individual people. Even someone with a low risk score and no symptoms could still have silent buildup of dangerous plaque in their arteries.
Lead author Dr. Anna Mueller says that many heart attacks happen in people who are considered low or medium risk.
She explains that we need to move away from waiting for symptoms to show and start looking for the actual plaque in the arteries using better imaging tools. Co-author Dr. Amir Ahmadi agrees and says it’s time to rethink how we prevent heart attacks.
This research shows the need for new ways to detect heart disease earlier, before it causes serious problems. It also shows that tools meant for tracking heart disease in large populations don’t always help doctors make the best decisions for each patient.
In the future, using imaging tests to look directly at plaque in the arteries could help doctors find hidden risks and start treatment earlier.
If you care about heart health, please read studies about how eating eggs can help reduce heart disease risk, and Vitamin K2 could help reduce heart disease risk.
For more information about health, please see recent studies that olive oil may help you live longer, and Vitamin C linked to lower risk of heart failure.
The study is published in JACC: Advances.
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