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

Emilio Fentanes, Miguel Cainzos Achirica, Khurram Nasir, Ron Blankstein*

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

1 Scopus citations


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.

Original languageEnglish
Article number73
JournalCurrent Atherosclerosis Reports
Issue number11
StatePublished - Nov 2021
Externally publishedYes


  • Coronary artery calcium
  • Primary prevention
  • Road map
  • Value-based clinical trials


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