Researchers from the Intermountain Healthcare Heart Institute in Salt Lake City are testing a new standard of care to better identify and treat people at risk of having a heart attack – and to potentially stop it before they ever have one.
The study, which will involve more than 90,000 people in Utah, could possibly change the way cardiovascular-related diseases are diagnosed in the future – and potentially save thousands of lives due to more accurate screening and better diagnosis.
The Intermountain Coronary Calcium (CorCal) study is seeking to determine the best way to proactively identify patients who may be at high risk for coronary heart disease to prevent a future heart event. Researchers will test the effectiveness of existing standard heart prevention guidelines (centered around cholesterol testing) compared to a novel strategy that includes performing a low-dose CT scan of the heart to screen for the build-up of calcium in the arteries.
The presence of coronary calcium indicates a build-up of atherosclerotic plaque in the arteries to the heart and brain and is associated with an increased risk of a future heart attack or stroke. Some patients enrolled in the study will undergo a CT heart scan, while others will not.
“The CorCal study will determine if adding a CT scan to the tests we already do will help to more accurately identify people that are at risk of a heart attack or stroke,” said J. Brent Muhlestein, M.D., principal investigator of the study, in a statement. Muhlestein is co-director of cardiovascular research at the Intermountain Healthcare Heart Institute.
Currently, the American Heart Association standard is to test a person’s cholesterol levels through a blood test called a “lipid panel.” Cholesterol levels are then used with other information to determine a person’s atherosclerotic cardiovascular disease risk score that is used to predict their risk of developing heart disease in the next 10 years and can guide healthcare providers in determining appropriate prevention treatments.
“Doing a CT scan will create a coronary artery calcium score. Looking at both scores together may identify people with coronary heart disease better than just using one score,” Dr. Muhlestein added. “It’s also possible that doing another test and looking at another score will not make any difference. Our goal is to find the test or group of tests that are the best at finding people with a risk of having a heart attack or stroke, so they can be prevented.”
Based on a person’s results, their primary care physicians may be notified if those people should start taking statins and/or aspirin to prevent potential future heart events.
Developing an accurate test and standard of care to determine a person’s risk of heart disease is vital. Heart disease is the single largest killer of American men and women – and about one-third of all heart-related deaths happen in people with no warning symptoms.
Researchers will use Intermountain’s electronic medical records system to identify patients who meet the study criteria, which includes being between 50 and 85 years old, not being on statins at the time of the study and having no known history of diabetes or vascular disease of the heart.
Researchers will be reaching out to 90,000 potential enrollees by mail and email and hope to enroll at least 9,000 into the randomized trial. The CorCal study is scheduled to run until March 2023.
