This is a prospective randomized controlled trial assessing the impact of notifying patients and their clinicians of an incidental finding of coronary artery calcification (CAC) indicating increased cardiovascular risk. Patients will be identified through completed radiology orders for non-gated, non-contrast chest CT in the appropriate clinical context and then will have an EHR screen for inclusion criteria. The presence of CAC will be confirmed by a radiologist. Eligible patients will be randomized to CAC notification or usual care using a 1:1 stratified block randomization method based on baseline ASCVD.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
PREVENTION
Masking
NONE
Enrollment
202
For patients randomized to notification, the affiliated non-EP cardiologist, if present, or if patient does not have one, the PCP will be notified and will receive an electronic health record (EHR) message notifying them of the presence of CAC (with images) and the ACC/AHA guideline recommendation to consider starting statin therapy. Simultaneously, the patient will be notified via a MyHealth message describing the presence of CAC with personalized scan images, its significance, and the recommendation that statin therapy should be considered. For the notification arm, we will check for either statin prescription or a documented discussion in the EHR at 2 months. For those not prescribed a statin and without a documented discussion in Epic at 2 months follow-up, we will send a repeat notification to their home address and to their affiliated clinician.
Stanford University
Stanford, California, United States
Number of new statin prescriptions
6-month new statin prescription rate
Time frame: Baseline through Month 6
Number of participants using statin medication
6-month assessment of statin prescription rates
Time frame: Month 6
Change in Low-density lipoprotein (LDL) cholesterol
Time frame: Baseline and Month 6
Change in 10-Year Atherosclerotic Cardiovascular Disease (ASCVD) Pooled Cohort Equation
This outcome measures the 10 year risk of ASCVD events.
Time frame: Baseline and Month 6
Number of events requiring primary care intervention, cardiology referrals, or cardiac testing
This outcome assesses healthcare resource use (primary care clinical encounters, cardiology referrals, cardiac testing).
Time frame: Baseline through Month 6
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.