Topol calls out cardiology's missed opportunities — from retinal scans to polygenic risk scores

At the American Heart Association Scientific Sessions in Chicago, renowned cardiologist Eric Topol, MD, delivered a pointed message: cardiologists are leaving powerful, proven tools on the table. From individualized exercise prescriptions to handheld ultrasound devices, Topol argued that the gap between what's available and what's actually used in practice is costing patients dearly.

Topol highlighted polygenic risk scores as a particularly glaring missed opportunity — capable of predicting risk for coronary artery disease, atrial fibrillation, and even aortic dissection, yet rarely deployed in clinical settings. He also championed AI-enabled imaging tools, noting that a single chest X-ray analyzed by AI can detect heart disease in under 2 seconds, outperforming traditional risk scores. Retinal imaging, he added, can predict a wide range of cardiovascular events in under 20 seconds — no pupil dilation needed.

Key Takeaways:

• Polygenic risk scores for CAD, AFib, and aortic dissection cost as little as $20 per SNP array but remain underutilized
• AI tools can analyze a chest X-ray for heart disease in under 2 seconds, surpassing standard atherosclerotic risk scores
• Retinal images can predict MI, stroke, and subclinical coronary atherosclerosis — and can be captured in under 20 seconds without dilation
• The FDA-approved fat attenuation index (CaRi-Heart) can quantify coronary artery inflammation but sees limited clinical use

Why it matters: These aren't futuristic technologies — they're available now. Wider adoption could enable earlier detection, more personalized prevention, and better outcomes for millions of cardiovascular patients.