JACC | The PROACT Study and Improving Prevention of ASCVD

The editorial highlights that the PROACT study introduces a novel genome-first strategy using polygenic
risk scores (PRS) to identify individuals who appear low-risk by traditional calculators but frequently
harbor subclinical coronary artery disease. It argues that prevention must evolve beyond age-based risk
models toward earlier, causal-factor–guided intervention integrating genomics, imaging, and targeted
therapy.