Patients whose statin advice was based on a coronary artery calcium scan were told to start the drugs far less often than patients assessed with a standard risk score, and they had the same rate of major heart events, the CorCal Outcomes trial found, according to the European Society of Cardiology. The trial still failed to prove that the scan approach was not worse, the society said in a release republished by ScienceDaily on Nov. 6.
Related: More health and medicine coverage.
What the trial tested
The trial enrolled 5,772 patients from the Canyons and Desert regions of Intermountain Health Care in the United States, the ESC said. None had known heart disease, diabetes or prior statin use. Their average age was 64, and 51% were women.
Patients were randomly assigned to statin guidance from the pooled cohort equations, a standard risk calculator, or from a CT scan that measures calcium in the heart’s arteries, according to the release. The final decision stayed with patients and their doctors.
What the results show
After an average of 4.2 years, 2.7% of patients in each group had a major event, a measure that combined death from any cause, heart attack, stroke and procedures to reopen arteries, the ESC said. The hazard ratio was 0.99.
The risk-score group was advised to start statins more than three times as often as the scan group, the society said. Among patients told to take statins, 62% of the scan group stuck with the drug, compared with 23% of the risk-score group.
Why the result is not a win
The trial did not meet its preset statistical test for noninferiority, the ESC said. Fewer patients had heart events than expected, which reduced the study’s power.
“We did not demonstrate noninferiority between the groups,” principal investigator Dr. Joseph B. Muhlestein of Intermountain Medical Center said in the release. He said the data could help plan a larger trial.
What happens next
European guidelines updated in 2025 already allow doctors to consider high calcium scores when assessing risk, particularly for patients near the treatment threshold, the ESC said. The results were presented at ESC Congress 2026. See more in Science.
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