Incidental Coronary Calcification Quality Improvement Project
Overview
- Phase
- Not Applicable
- Intervention
- Not specified
- Conditions
- Atherosclerotic Cardiovascular Disease
- Sponsor
- Stanford University
- Enrollment
- 173
- Locations
- 1
- Primary Endpoint
- Rate of Statin Prescription
- Last Updated
- 3 years ago
Overview
Brief Summary
This is a multi-center, randomized quality improvement project. At least 200 statin-naïve patients without a history of atherosclerotic cardiovascular disease with incidental coronary artery calcium (CAC) on a prior non-gated chest CT will be enrolled across the Stanford Healthcare System and the Palo Alto Veteran's Affairs Healthcare System. Patients will be randomized in a 1:1 fashion to notification or usual care arms. The primary aim of this project is to estimate the increase in 6-month statin prescription among statin-naïve patients without a history of atherosclerotic cardiovascular disease with incidental CAC on a non-gated chest CT who are randomized to receive notification of their findings vs. usual care.
Investigators
Alexander Sandhu
Principal Investigator, Instructor of Medicine, Division of Cardiology
Stanford University
Eligibility Criteria
Inclusion Criteria
- •Non-gated chest CT between 2014-2019
- •The presence of CAC confirmed by manual review by an experienced radiologist
- •Stanford affiliated primary care provider or endocrinologist for Stanford healthcare system patients and VA primary care provider for VA patients with at least 1 encounter since 2018
Exclusion Criteria
- •Current or prior statin or PCSK9 inhibitor therapy
- •Prior diagnosis of ASCVD (coronary artery disease, peripheral arterial disease, cerebrovascular disease, coronary/peripheral revascularization)
- •Prior coronary imaging (cardiac CT, invasive coronary angiography)
- •Metastatic cancer or active cancer undergoing chemotherapy
- •History of medical nonadherence
Outcomes
Primary Outcomes
Rate of Statin Prescription
Time Frame: Within 6 months
Proportion of patients prescribed a statin
Secondary Outcomes
- Number of primary Care Clinical Encounters(6 months)
- Number of Cardiology Referrals(6 months)
- LDL Cholesterol Level(6 months)
- Systolic Blood Pressure(6 months)
- Hemoglobin A1c Level(6 months)
- Statin Intensity(6 months)
- HDL Cholesterol Level(6 months)
- Rate of Aspirin Prescription(6 months)
- Total Cholesterol Level(6 months)
- Number of Cardiovascular Diagnostic Tests(6 months)
- Triglyceride Level(6 months)
- Number of Hypertension Medications(6 months)
- Body Mass Index(6 months)
- Pooled cohort equations estimated 10-year risk of atherosclerotic cardiovascular disease(6 months)