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The Role of Coronary Artery Calcium Testing for Value-Based Clinical Trials in Primary Prevention

  • Evidence-Based Medicine, Clinical Trials and Their Interpretations (K. Nasir, Section Editor)
  • Published:
Current Atherosclerosis Reports Aims and scope Submit manuscript

Abstract

Purpose of Review

Review the role of coronary artery calcium (CAC) testing in designing future clinical trials in primary prevention.

Recent Findings

While there are numerous new agents that have been found to lower cardiovascular event rates in clinical trials, these studies have required a large sample size, in part due to low event rates as well as improved baseline treatments. More precise risk assessment could allow for better identification of individuals who stand to derive the most benefit from various therapies. Coronary CAC testing offers a simple method for identifying high-risk primary prevention cohorts, and thus may allow for improved efficiency of clinical trials, enhanced efficacy of various therapies, and ultimately more favorable cost-effectiveness estimates.

Summary

The use of CAC testing as part of the inclusion criteria used in clinical trials may result in identifying high-risk individuals who were previously not included in such studies while achieving favorable absolute risk reductions. The advantages afforded by using CAC to enrich clinical trials offer a potential road map for future clinical trials in primary prevention.

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Author information

Authors and Affiliations

  1. Division of Cardiovascular Medicine, Brigham and Women’s Hospital, Boston, MA, USA

    Emilio Fentanes & Ron Blankstein

  2. Division on Cardiovascular Prevention and Wellness, Houston Methodist, Weill Cornell Medical College, Houston, TX, USA

    Miguel Cainzos Achirica & Khurram Nasir

Authors
  1. Emilio Fentanes
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  2. Miguel Cainzos Achirica
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  3. Khurram Nasir
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  4. Ron Blankstein
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Corresponding author

Correspondence to Ron Blankstein.

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Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

Conflict of Interest

Dr. Khurram Nasir is on the Advisory Boards of Amgen, Novartis, and Novo Nordisk. His research is partly supported by the Jerold B. Katz Academy of Translational Research.

Dr. Blankstein has received research support from Amgen Inc. and Novartis Inc; and is on the Advisory boards of Caristo and Roivant Sciences Inc, outside the submitted work.

The other authors report no conflicts of interest.

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This article is part of the Topical Collection on Evidence-Based Medicine, Clinical Trials and Their Interpretations

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Fentanes, E., Cainzos Achirica, M., Nasir, K. et al. The Role of Coronary Artery Calcium Testing for Value-Based Clinical Trials in Primary Prevention. Curr Atheroscler Rep 23, 73 (2021). https://doi.org/10.1007/s11883-021-00969-6

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  • DOI: https://doi.org/10.1007/s11883-021-00969-6

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