Clinical Workflow for Multimodal CAD Risk Stratification.

Data from four key domains (Baseline EHR/Clinical, Imaging, Genomics, and Signals/Wearables) are integrated into a validated multimodal fusion model. The model outputs actionable risk strata, guiding personalized clinical decisions as outlined in the practical notes.

Practical Notes:

• CAC=0 may support deferring statins in low/intermediate risk

• Very high PRS may prompt earlier imaging/intensification

• Wearable-device alerts trigger clinical review but not autonomous therapy

• Ensure fairness and consider federated learning for privacy

ABPM, ambulatory blood pressure monitoring; BP, blood pressure; CAC, coronary artery calcium; CCTA, coronary computed tomography angiography; CMR, cardiac magnetic resonance; CT-FFR, computed tomography-derived fractional flow reserve; DM, diabetes mellitus; ECG, electrocardiogram; EHR, electronic health record; PCAT, pericoronary adipose tissue; PCG, phonocardiogram; PET, positron emission tomography; PRS, polygenic risk score; SPECT, single-photon emission computed tomography.