The traditional primary prevention paradigm for coronary artery disease (CAD) centers on population-based algorithms to classify individual risk. However, this approach often misclassifies individuals and leaves many in the ‘intermediate’ category, for whom there is no clear preferred prevention strategy. Coronary artery calcium (CAC) and polygenic risk scoring (PRS) are two contemporary tools for risk prediction to enhance the impact of effective management.
To determine how these CAC and PRS impact upon adherence to pharmacotherapy and lifestyle measures in asymptomatic individuals with subclinical atherosclerosis.
The CAPAR-CAD study is a multi-centre, open, randomised controlled trial in Victoria, Australia. Participants are self-selected individuals aged 40 to 70 years with no prior history of cardiovascular disease (CVD), intermediate 10-year risk for CAD as determined by the pooled cohort equation (PCE), and CAC score >0. All participants will have a health assessment, a full CT coronary angiogram (CTCA), and PRS calculation. They will then be randomised to receive their risk presented either as PCE and CAC, or PCE and PRS. The intervention includes e-Health coaching focused on risk factor management, health education and pharmacotherapy, and follow-up to augment adherence to statin medication. The primary endpoint is change in low density lipoprotein cholesterol (LDL-C) from baseline to 12 months. The secondary endpoint is between-group differences in behaviour modification and adherence to statin pharmacotherapy.
As at 31 July 2021 we have screened 1903 individuals. We present the results of the 574 participants deemed eligible after baseline assessment.

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