• The amount of carotid plaque mirrors your risk for stroke and myocardial infarction. Only by having the information of TPA in your carotid arteries it becomes in general possible to decide, how agressively your risk for stroke and myocardial infarction should be treated. 
• Do not use calcium scoring first. Use TPA, it's so much easier.

• TPA is a measure of atherosclerosis and the total plaque burden within your carotid arteries.

• TPA is a completely safe ultrasound based test which says more than many other test in medicine with regard to your risk for myocardial infarction and stroke with a diagnostic accuracy of around 77% (area under the curve AUC), and this test takes only 2-5 minutes!
• TPA will replace in most patients calcium scoring with its inherent radiation burden
• TPA is used to track atherosclerotic disease. This serves to better treat the Nr 1 killer of humanity.

• Improved and earlier detection of atherosclerosis 

• Targeted prevention - not every one with elevated cholesterol needs a statin !

• Help GP's to better prevent sequalae of atherosclerosis in their primary care patients

• Communication of the need to use TPA

• Generation of a large scientific and financial base for TPA measurements in Switzerland

TPA integration in clinical management of atherosclerosis

Diagnostic Strategies

• For every given pretest probability, e.g. assessed by PROCAM or SCORE, the TPA posttest probability for your 10 year risk can be precisely calculated using the Bayes formula. This way of posttest risk calculation is revolutionary in medicine and was developed by Kardiolab in order to compare ROC curves of tests predictive of vascular events.

• better assessment of the true risk for AMI and STROKE

• more convincing to change bad habits, when images are used instead of words

• helps to reassess your risk as being high instead of intermediate or low

• better assessment of the need for lipid lowering drungs

• helps stop smoking faster

• can be used for atherosclerosis tracking: in case of plaque growth, a closer look at cardiovascular risk factors is needed.

• number needed to treat in intervention studies: per group and year only about 60 persons needed (for IMT: about 400 personen needed). 

• Comparison of TPA and calcium scores in the same person: helps to answer the question, in which cases TPA may replace calcium scoring. Data on file Kardiolab, N about 400.

• TPA and vascular morbidity and mortality: assessment of correlations. Data on file Kardiolab, N about 1000

• Comparison of IMT and TPA with conventional risk factors. Data on file Kardiolab, N about 225.

• TPA used on a practice based level for atherosclerosis tracking, N about 700 with follow-up of 1-5 years.

• trained MDs and Assistents from Angiology, Neurology, Angiology, Cardiology ecc) with TPA certificates.

• More comparative studies, e.g. with IMT or the newly developed Atherosclerosis Burden Score (ABS: CHUV, Prof. Darioli)

• centralized national data pool for TPA, constant monitoring of TPA test performance for outcome data