Cardiology over the next ten years

Risposta: As already mentioned, a shift is underway towards an increasingly predictive, personalised and precision-based form of medicine, capable of using clinical data and a patient’s individual characteristics to anticipate risks and guide treatment choices in an increasingly targeted manner. The ability to integrate clinical data, advanced cardiovascular imaging, biomarkers and genetic information – including through the use of artificial intelligence tools – will enable us to define an individual’s risk profile with greater accuracy and to identify the early stages of disease at a much earlier stage, when timely intervention can offer the greatest benefit.

In cardiology, this transformation is already evident. Coronary CT, for example, not only allows the degree of stenosis to be quantified but also enables the extent of atherosclerosis and certain prognostic features of the plaque to be assessed, thereby providing a more comprehensive characterisation of the disease burden and certain factors associated with its progression. Artificial intelligence will be able to integrate this information with clinical and biological data, offering increasingly sophisticated tools to support medical decision-making.

At the same time, cardiovascular pharmacology is moving towards more selective therapies, directed at specific biological targets: from lipid metabolism, with the inhibition of PCSK9 and future strategies targeting lipoprotein(a), to inflammatory mechanisms and the broader cardio-renal-metabolic axis. Innovation will therefore concern not only the availability of new medicines but also the possibility of intervening in an increasingly targeted manner on the determinants of so-called residual risk – that is, the portion of risk that persists despite optimal management of traditional risk factors.

True innovation lies not merely in having new technologies at our disposal, but in knowing how to integrate them into care pathways that offer each patient the appropriate treatment at the right time and with the right intensity, based on their individual clinical profile.

Technology, in fact, realises its full value when it becomes a practical tool at the service of patients and doctors, capable of supporting more accurate and timely decisions. This approach moves away from a ‘one-size-fits-all’ approach to medicine, favouring strategies that are increasingly personalised and adaptable to the progression of the disease. In this way, innovation and clinical expertise can work together to improve the effectiveness of treatment and people’s quality of life.