Breakthrough in cardiovascular risk assessment and management

People with silent atherosclerosis are now identified using imaging techniques and receive our recommendations for the secondary prevention of their cardiovascular disease. Imaging has become a central tool for the risk management of atherosclerosis and shifts patients from primary to secondary prevention.

The Federal Office of Public Health accepted our breakthrough report on their prevention website in October 2025. This confirms the need for a method to treat and detect atherosclerosis without radiation and at a lower cost while maintaining excellent cost-effectiveness., realiability, reproducibility and diagnostic and prognostic accuaracy, as reported in an overview article in the American Journal of Echocardiography in 2022.

Thanks to Swiss research, the importance of imaging atherosclerosis with a simple ultrasound test in the diagnosis and management of atherosclerosis is being recognized and increasingly put into practice. Compared with the information obtained from computed tomography of the coronary arteries with and without contrast agents, recent research shows that ultrasound of the carotid arteries—with determination of the total plaque burden –

  1. detects vulnerable patients earlier,
  2. is prognostically equivalent to coronary CT, and
  3. is clearly superior to coronary CT in terms of monitoring preventive effects, costs, and the lack of environmental impact and patient radiation exposure.

Current evidence allows us to conclude that in the secondary prevention of atherosclerosis, a paradigm shift away from computed tomography and toward carotid ultrasound is scientifically sound and thus the primary examination module for detecting prognostically relevant atherosclerosis.

There are 7 reasons why carotid ultrasound is the preferred imaging method over coronary CT and angiography in the preventive setting:

  1. No costs: only consultation costs are incurred (the test usually takes less than 2 minutes and can be performed in any doctor’s office with a linear ultrasound probe).
  2. Two-tier healthcare: The coronary calcium test must be paid for privately, which creates a two-tier healthcare system.
  3. No radiation exposure: Coronary calcification is associated with radiation exposure of just under 1 mSv.
  4. cTPA gatekeeper for cardiac CT: The measurement of coronary calcification using computed tomography should only be performed after the cTPA measurement, i.e., if relevant coronary calcification is suspected despite a normal cTPA measurement.
  5. No environmental impact: Compared to computed tomography, the cTPA test requires virtually no resources (minimal power consumption, no environmental damage).
  6. Follow-up checks: cTPA can be used to determine the progression or regression of atherosclerosis after just 3 months [21], which is a strong motivator for adhering to preventive measures. After a short training session, it can be easily performed in a point-of-care situation, i.e., in a general practitioner’s office (like blood pressure or blood sugar checks). whereas such observations using computed tomography are prohibitive due to the costs and radiation exposure (at least 4 mSv per computed tomography scan for contrast-enhanced examination of non-calcified plaque load per examination) and, in addition, coronary calcifications increase under preventive treatment (doi: 10.1016/j.jacc.2015.01.036)
  7. False sense of security: around 25% of women in particular have relevant carotid plaques without coronary calcification and are also more likely than men (25% versus 9%) to suffer cardiovascular events (Nixdorf Recall Study doi: 10.3238/arztebl.m2022.0360.).

We invite scientists and opinion leaders to support our efforts for the implementation of the cTPA method in clinical practice, be it through presence on our website or through co-authorship (proof reading) of our scientific publications or through opinion articles in the press.

Just below you find 3 overview articles to get rapidly into touch with all the informations required for your support decision.

Overview Articles

  1. Varifo Report englisch: Carotid plaque is superior to coronary calcifications
    Link to summary paper, english
  2. Varifo Bericht deutsch: Karotisplaque sind dem Koronarkalktest ebenbürtig oder überlegen Link zum Varifo Bericht, Deutsch
  3. Artikel für https://prevention.ch: Karotisplaque sind dem Koronarkalktest ebenbürtig oder überlegen (Bericht für https://www.prevention.ch/organisation/vascular-risk-foundation) Link zum Varifo Bericht, Deutsch

Scientific Papers

Just below you find 6 scientific papers . This webpage informs co-authors about the content of the papers for proof reading. Rapid Fire oral presentation SSC 2024/2025 are available here.

  1. Scientific Paper 1: Carotid Plaque appear earlier than coronary calcifications scientific paper for proof reading:
    Link to scientific paper
  2. Scientific Paper 2: Carotid Plaque have same prognostic information as coronary calcifications Link to scientific paper
  3. Scientific Paper 3: Carotid Plaque Regression reduces cardiovascular risk by about 50% Link to scientific paper
  4. Scientific Paper 4: Indication for Aspirin prevention based upon amounts of carotid plaques (work in progress)
  5. Scientific Paper 5: Very high risk findings from carotid plaques (work in progress)
  6. Scientific Paper 6: Preventive potential for all cause disease rsik reduction, a compression of disease simulation (work in progress)

For further information contact Michel Romanens, MD, by email: michel.romanens@varifo.ch