CAC Scans Cut Statin Advice, Nearly Tripled Adherence — SkimNews
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- CorCal Outcomes randomized 5,772 patients with no known ASCVD or diabetes and no prior statin use to guidance based on pooled cohort equations or coronary artery calcium scans; 51% were women.
- Pooled cohort equations produced statin recommendations more than three times as often as coronary artery calcium scoring in the trial.
- Major cardiovascular events occurred in 2.7% of each group after an average 4.2 years, with a hazard ratio of 0.99 and a 95% confidence interval of 0.71 to 1.38.
- CorCal Outcomes failed its predetermined statistical requirement for noninferiority; researchers said lower-than-expected event rates reduced the trial’s power to detect a meaningful difference.
- Patients advised after a calcium scan had 62% statin adherence, versus 23% among those advised through traditional risk assessment—approximately 2.7 times the rate; the trial did not establish why.
- 2025 Focused Update of the 2019 ESC/EAS Guidelines already recommends considering elevated coronary calcium scores, when available, as an additional risk-assessment factor, particularly for people at moderate cardiovascular risk.
Why it matters: For patients and clinicians choosing prevention, CAC-guided care showed a clear efficiency contrast: far fewer statin recommendations, with 62% adherence among those advised versus 23% under risk-score guidance. But 2.7% event rates in either group did not establish noninferiority, and the investigators call for better-powered trials rather than replacing standard risk assessment.
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