A new study by researchers from Mount Sinai Hospital has revealed a serious flaw in common risk assessment tools for heart disease. These tools often fail to identify nearly half of the people who are actually at risk of a heart attack, even just days before it occurs. The findings, published in the 'Journal of the American College of Cardiology', suggest that current preventive guidelines may overlook individuals who could benefit from early detection and treatment. The team evaluated the accuracy of two common tools: the Atherosclerotic Cardiovascular Disease (ASCVD) risk score and the newer 'PREVENT' tool. Researchers noted that relying on risk assessments and symptom reports as primary indicators for prevention 'is not optimal', calling for 'a radical rethinking of this model and a shift towards imaging atherosclerosis to identify silent plaques before they have a chance to rupture.' The study included data from 474 patients under the age of 66 who were treated for their first heart attack. The research confirmed that 'a low-risk score and the absence of traditional symptoms do not guarantee individual safety'. According to the risk assessment for each patient two days before their event, the results showed that 45% of patients would not have qualified for preventive treatment or additional screenings under the ASCVD tool, and this figure rose to 61% using the PREVENT tool. Furthermore, the study revealed that 60% of patients did not notice symptoms such as chest pain or shortness of breath until less than two days before their heart attack, indicating that symptoms often appear only after the disease has progressed significantly. Dr. Anna Mueller, the lead researcher, commented: 'When we look at heart attacks and trace them back in time, we find that most of them occur in patients from low or moderate-risk categories.'
