TY - JOUR
T1 - Use of coronary computed tomography or polygenic risk scores to prompt action to reduce coronary artery disease risk
T2 - the CAPAR-CAD trial
AU - Verma, Kunal P.
AU - Marwick, Thomas H.
AU - Duarte, Carla
AU - Meikle, Peter
AU - Inouye, Mike
AU - Carrington, Melinda J.
N1 - Funding Information:
CAPAR-CAD is a multi-site, open, randomized controlled trial. The study flow diagram over 12 months follow-up is shown in Figure 1 . CAPAR-CAD is nested within a much larger observational study (EDCAD-PMS). The final study protocol (Version 3.0; September 30, 2020) was approved by the Alfred Hospital Ethics Committee (Project number: 492/20) and the Tasmanian Human Research Ethics Committee (Project number: H0024000; approved April 14, 2021). The umbrella EDCAD-PMS trial was prospectively registered on clinicaltrials.gov (NCT04604353). This research is supported by philanthropic funding from the Ernest Heine Family Foundation. The authors are solely responsible for the design and conduct of this study, all study analyses, the drafting and editing of the paper, and its final contents.
Publisher Copyright:
© 2022 Elsevier Inc.
PY - 2022/6
Y1 - 2022/6
N2 - Background: The traditional primary prevention paradigm for coronary artery disease (CAD) centers on population-based algorithms to classify individual risk. However, this approach often misclassifies individuals and leaves many in the ‘intermediate’ category, for whom there is no clear preferred prevention strategy. Coronary artery calcium (CAC) and polygenic risk scoring (PRS) are 2 contemporary tools for risk prediction to enhance the impact of effective management. Aims: To determine how these CAC and PRS impact adherence to pharmacotherapy and lifestyle measures in asymptomatic individuals with subclinical atherosclerosis. Methods: The CAPAR-CAD study is a multicenter, open, randomized controlled trial in Victoria, Australia. Participants are self-selected individuals aged 40 to 70 years with no prior history of cardiovascular disease (CVD), intermediate 10-year risk for CAD as determined by the pooled cohort equation (PCE), and CAC scores >0. All participants will have a health assessment, a full CT coronary angiogram (CTCA), and PRS calculation. They will then be randomized to receive their risk presented either as PCE and CAC, or PCE and PRS. The intervention includes e-Health coaching focused on risk factor management, health education and pharmacotherapy, and follow-up to augment adherence to a statin medication. The primary endpoint is a change in low-density lipoprotein cholesterol (LDL-C) from baseline to 12 months. The secondary endpoint is between-group differences in behavior modification and adherence to statin pharmacotherapy. Results: As of July 31, 2021, we have screened 1,903 individuals. We present the results of the 574 participants deemed eligible after baseline assessment.
AB - Background: The traditional primary prevention paradigm for coronary artery disease (CAD) centers on population-based algorithms to classify individual risk. However, this approach often misclassifies individuals and leaves many in the ‘intermediate’ category, for whom there is no clear preferred prevention strategy. Coronary artery calcium (CAC) and polygenic risk scoring (PRS) are 2 contemporary tools for risk prediction to enhance the impact of effective management. Aims: To determine how these CAC and PRS impact adherence to pharmacotherapy and lifestyle measures in asymptomatic individuals with subclinical atherosclerosis. Methods: The CAPAR-CAD study is a multicenter, open, randomized controlled trial in Victoria, Australia. Participants are self-selected individuals aged 40 to 70 years with no prior history of cardiovascular disease (CVD), intermediate 10-year risk for CAD as determined by the pooled cohort equation (PCE), and CAC scores >0. All participants will have a health assessment, a full CT coronary angiogram (CTCA), and PRS calculation. They will then be randomized to receive their risk presented either as PCE and CAC, or PCE and PRS. The intervention includes e-Health coaching focused on risk factor management, health education and pharmacotherapy, and follow-up to augment adherence to a statin medication. The primary endpoint is a change in low-density lipoprotein cholesterol (LDL-C) from baseline to 12 months. The secondary endpoint is between-group differences in behavior modification and adherence to statin pharmacotherapy. Results: As of July 31, 2021, we have screened 1,903 individuals. We present the results of the 574 participants deemed eligible after baseline assessment.
UR - http://www.scopus.com/inward/record.url?scp=85127237535&partnerID=8YFLogxK
U2 - 10.1016/j.ahj.2022.02.007
DO - 10.1016/j.ahj.2022.02.007
M3 - Article
C2 - 35218726
AN - SCOPUS:85127237535
SN - 0002-8703
VL - 248
SP - 97
EP - 107
JO - American Heart Journal
JF - American Heart Journal
ER -
