Prevention & lipidsRandomised controlled trial
Effects of Combining Coronary Calcium Score With Treatment on Plaque Progression in Familial Coronary Artery Disease
- Randomised controlled trial
- open-blinded end point
- prospective
- 7 hospitals across Australia
Authors' conclusion
The combination of CAC score with a primary prevention strategy in intermediate-risk patients with a family history of CAD was associated with reduction of atherogenic lipids and slower plaque progression compared with usual care.
Study context
- Population
- Asymptomatic intermediate-risk adults aged 40–70 y with a family history of premature coronary artery disease (CAD) and coronary artery calcium (CAC) score >0 but <400
- Participants
- 365 adults
- Comparison
- CAC score-informed prevention vs usual care
- CAC score-informedn = 179
- Usual caren = 186reference
- Primary endpoint
- Total plaque volume progression on coronary computed tomography angiography (CCTA) (core laboratory)
- Follow-up
- 3 years
Primary result
As reported in the abstract
Total plaque volume progression
P = 0.009
Further findings
Noncalcified plaque volume progression · 3 years
P = 0.002
Mean, mm3
| Outcome | CAC score-informed | Usual care | P value |
|---|---|---|---|
| Fibrofatty and necrotic core plaque volume progression · 3 years | −0.8 (SD 12.6) | 4.5 (SD 25.8) | P = 0.02 |
Total and LDL cholesterol change; pooled cohort equation risk · 3 years
- Sustained reduction in total cholesterol with CAC score-informed vs usual care (mean [SD])
- −3 [31] mg/dL vs −56 [38] mg/dL; P < .001
- Sustained reduction in LDL cholesterol with CAC score-informed vs usual care (mean [SD])
- −2 [31] vs −51 [36] mg/dL; P < .001
- Reduction in pooled cohort equation risk (mean [SD])
- 2.1% [2.9%] vs 0.5% [2.9%]; P < .001
Original publication
Effects of Combining Coronary Calcium Score With Treatment on Plaque Progression in Familial Coronary Artery Disease. JAMA. Published 22 April 2025. doi:10.1001/jama.2025.0584
Summarised from the published abstract; every number is checked against it