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Rationale and design of a trial to personalize risk assessment in familial coronary artery disease


Marwick, TH and Whitmore, K and Nicholls, SJ and Stanton, T and Mitchell, G and Tonkin, A and Blizzard, C and Neil, A and Jones, C and Watts, GF, on behalf of the CAUGHT-CAD Investigators, Rationale and design of a trial to personalize risk assessment in familial coronary artery disease, American Heart Journal, 199 pp. 22-30. ISSN 0002-8703 (2018) [Contribution to Refereed Journal]

Copyright Statement

2017 Elsevier Inc. All rights reserved.

DOI: doi:10.1016/j.ahj.2017.09.011


Background: The lifetime risk of coronary artery disease (CAD) is doubled in people with a family history of premature disease, yet this risk is not captured in most 5- or 10-year risk assessment algorithms. Coronary artery calcium scoring (CCS) is a marker of subclinical CAD risk, which has been shown in observational studies to provide prognostic information that is incremental to clinical assessment; is relatively inexpensive; and is performed with a small radiation dose. However, the use of CCS in guiding prevention is not strongly supported by guidelines. Showing definitive evidence of the efficacy and costeffectiveness of CCS is therefore of importance.

Study design: The proposed randomized controlled trial of the use of CCS will be targeted to 40- to 70-year-old first-degree relatives of patients with CAD onset <60 years old or second-degree relatives of patients with onset <50 years old. Control patients will undergo standard risk scoring and be blinded to CCS results. In the intervention group, primary prevention in patients undergoing CCS will be informed by this score. At 3 years, effectiveness will be assessed on change in plaque volume at computed tomography coronary angiography, the extent of which has been strongly linked to outcome.

Summary: The CAUGHT-CAD trial will provide evidence to inform the guidelines regarding the place of CCS in decision making regarding primary prevention of patients with a family history of premature disease.

Item Details

Item Type:Contribution to Refereed Journal
Keywords:coronary artery disease, risk assessment, family history, coronary artery calcium scoring, trial design
Research Division:Biomedical and Clinical Sciences
Research Group:Cardiovascular medicine and haematology
Research Field:Cardiology (incl. cardiovascular diseases)
Objective Division:Health
Objective Group:Clinical health
Objective Field:Clinical health not elsewhere classified
UTAS Author:Whitmore, K (Mrs Kristyn Whitmore)
UTAS Author:Blizzard, C (Professor Leigh Blizzard)
UTAS Author:Neil, A (Associate Professor Amanda Neil)
ID Code:121559
Year Published:2018
Web of Science® Times Cited:10
Deposited By:Menzies Institute for Medical Research
Deposited On:2017-10-03
Last Modified:2019-12-23

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