Incidental Coronary Calcification Quality Improvement Project

Stanford University173 enrolled

Overview

This is a multi-center, randomized quality improvement project. At least 200 statin-naïve patients without a history of atherosclerotic cardiovascular disease with incidental coronary artery calcium (CAC) on a prior non-gated chest CT will be enrolled across the Stanford Healthcare System and the Palo Alto Veteran's Affairs Healthcare System. Patients will be randomized in a 1:1 fashion to notification or usual care arms. The primary aim of this project is to estimate the increase in 6-month statin prescription among statin-naïve patients without a history of atherosclerotic cardiovascular disease with incidental CAC on a non-gated chest CT who are randomized to receive notification of their findings vs. usual care.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

OTHER

Masking

NONE

Enrollment

173

Conditions

Atherosclerotic Cardiovascular Disease Coronary Artery Disease

Interventions

Eligibility

Sex: ALLMin age: 18 YearsMax age: 85 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Non-gated chest CT between 2014-2019 * The presence of CAC confirmed by manual review by an experienced radiologist * Stanford affiliated primary care provider or endocrinologist for Stanford healthcare system patients and VA primary care provider for VA patients with at least 1 encounter since 2018 Exclusion Criteria: * Current or prior statin or PCSK9 inhibitor therapy * Prior diagnosis of ASCVD (coronary artery disease, peripheral arterial disease, cerebrovascular disease, coronary/peripheral revascularization) * Prior coronary imaging (cardiac CT, invasive coronary angiography) * Dementia * Metastatic cancer or active cancer undergoing chemotherapy * History of medical nonadherence

Outcomes

Primary Outcomes

Rate of Statin Prescription

Proportion of patients prescribed a statin

Time frame: Within 6 months

Secondary Outcomes

Statin Intensity

Proportion of patients prescribed a high intensity, intermediate intensity, and low intensity statin

Time frame: 6 months

Total Cholesterol Level

Time frame: 6 months

LDL Cholesterol Level

Time frame: 6 months

HDL Cholesterol Level

Time frame: 6 months

Triglyceride Level

Time frame: 6 months

Systolic Blood Pressure

Time frame: 6 months

Number of Hypertension Medications

Time frame: 6 months

Hemoglobin A1c Level

Time frame: 6 months

Body Mass Index

Time frame: 6 months

Pooled cohort equations estimated 10-year risk of atherosclerotic cardiovascular disease

Time frame: 6 months

Rate of Aspirin Prescription

Proportion of patients prescribed aspirin

Time frame: 6 months

Number of primary Care Clinical Encounters

Time frame: 6 months

Number of Cardiology Referrals

Time frame: 6 months

Number of Cardiovascular Diagnostic Tests

Time frame: 6 months

Incidental Coronary Calcification Quality Improvement Project

Overview

Conditions

Interventions

Eligibility

Locations (1)

Outcomes

Primary Outcomes

Secondary Outcomes