Keynote speaker: Missed opportunities could lead to great discoveries
There is nothing more heartbreaking than a squandered opportunity or a missed chance. Eric Topol, MD, founder and director of the Scripps Research Translational Institute, urged attendees at the opening session of Scientific Sessions 2026 to embrace every missed opportunity as a chance to discover more during “Missed Opportunities in Cardiovascular Medicine.”
“This is going to be quick,” he joked. “It’s going to be like Last Week Tonight With John Oliver.”
Topol, who is one of the most cited researchers in medicine and author of Deep Medicine and Super Agers, riffed through multiple cardiovascular conditions, tests and devices that could deliver cardiovascular discovery by taking advantage of accessible information.
- Exercise activity. Topol cited activity as the No. 1 thing to promote youthful aging, especially of the cardiovascular system. He encouraged the audience to take detailed histories of each patient’s activities, creating an individualized plan for each person.
- Sleep regularity and sleep quality. Second to exercise activity, Topol said sleep is highly correlated with cardiovascular favorable outcomes.
- Polygenic risk scores. Using an independent assessment from family history and other risk factors, polygenic risk scores can predict the risk of coronary disease. “An exquisite definition of risk that we’re not using,” he said.
- Genomic assessment: Topol questioned why the cardiovascular community was not conducting a genomic assessment for a number of conditions. The conditions included abnormally wide aortas, clonal hematopoiesis and aortic aneurysms.
- Devices. He suggested the six-lead ECGs could provide “more insight about conduction disturbances, which you’re not going to get from a pulse.” It can be completed in just a few seconds in each patient, with or without taking their pulse.
- Using AI for medical scan interpretation. Topol pointed to medical imaging such as chest X-rays, CT, mammography, echocardiograms and MRIs as obvious areas that AI could examine and provide detailed evidence of abnormalities.
“Every single type of medical image has a rich embedment of data that is left on the table.” For example, he said a single chest X-ray is better than the atherosclerotic cardiovascular risk score. “Why aren’t we using it for patients as a way to assess their risk?”
Topol advocated for the intelligent use of AI with ECGs to better diagnose at-risk patients.
“AI is not being used to interpret cardiograms, except in a few health systems in this country, like Mayo Clinic,” Topol said. There is so much more that can be “derived from a cardiogram about, for example, future atrial fibrillation risk and future stroke risk in people in normal sinus rhythm.”
Topol also pointed to mammograms and retinal scans as rich medical images that are being underused in gathering so much more information about cardiovascular health.
“The retina, the most-rich medical image … looking at blood vessels and nerves in one photo, tells us about subclinical atherosclerosis. You can calculate the heart calcium score; you can predict heart attack, stroke risk.
In identifying these missed opportunities, Topol insisted future discoveries are there for the taking by the cardiovascular community. “We can do this,”
he said.
