That's the main contention point, believe it or not current standard for heart diseases risk prediction method do not include the 'elephant in the room' ECG.

There are many related research work with excellent results, patent, etc by biomedical researchers around the world that I'd care to mention, including yours truly. Biomedical researchers even has yearly global competition organized so called CINC that used ECG as one of the main input for heart disease risk prediction since it's readily available [1].

In particular check out work by Prof. Friedman on ECG [2]. Somehow his excellent work is mostly being ignored by AHA and their counterparts because apparently these standard risk prediction models in US and Europe are not including it as part of their parameters.

[1] Computing in cardiology (CINC):

https://cinc.org/

[2] The Electrocardiogram at 100 Years: History and Future:

https://www.ahajournals.org/doi/pdf/10.1161/CIRCULATIONAHA.1...