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Health Enhanced Artery Risk Tracking With Widespread Implementation and Screening Effort in ASCVD (HEARTWISE-ASCVD) (HEARTWISE)

11 november 2026 bijgewerkt door: Fatima Rodriguez, Stanford University

Health Enhanced Artery Risk Tracking With Widespread Implementation and Screening Effort in AtheroSclerotic CardioVascular Disease (HEARTWISE-ASCVD) Studie

This multi-site study will test whether an opportunistic AI-based CAC screening and notification intervention can improve cholesterol treatment and lower cholesterol levels in adults. The study uses artificial intelligence to detect calcium buildup in heart arteries (coronary artery calcium or CAC) on chest CT scans that patients have already had for other reasons. The study will focus on adults who either have known atherosclerotic cardiovascular disease (ASCVD) or have significant calcium buildup (a CAC score of 100 or higher), and whose cholesterol is not well controlled.

It will also evaluate how well this approach can be implemented at scale across multiple health systems. The main questions it aims to answer are:

Does notifying patients and their clinicians about incidental CAC increase lipid-lowering therapy(LLT) initiation or intensification?

Does the intervention improve Low-Density Lipoprotein(LDL)-cholesterol control and related lipid testing?

How does the intervention affect downstream care (e.g., clinic visits, cardiology referrals, and cardiac testing)?

Researchers will use an FDA-cleared AI algorithm to quantify CAC on previously performed non-gated chest CT scans and identify eligible participants through the electronic health record. Participants will be randomized to receive CAC notification either right away or after a 6-month delay.

Studie Overzicht

Toestand

Aanmelden op uitnodiging

Conditie

Interventie / Behandeling

Studietype

Ingrijpend

Inschrijving (Geschat)

12000

Fase

  • Niet toepasbaar

Contacten en locaties

In dit gedeelte vindt u de contactgegevens van degenen die het onderzoek uitvoeren en informatie over waar dit onderzoek wordt uitgevoerd.

Studie Locaties

  • Verenigde Staten
    • California
      • Los Angeles, California, Verenigde Staten, 90095
        • University of California, Los Angeles
      • Pleasanton, California, Verenigde Staten, 94588
        • Kaiser Permanente Northern California
      • Stanford, California, Verenigde Staten, 94305
        • Stanford University
    • North Carolina
      • Durham, North Carolina, Verenigde Staten, 27710
        • Duke University Medical Center
    • Tennessee
      • Nashville, Tennessee, Verenigde Staten, 37232
        • Vanderbilt University Medical Center
    • Texas
      • Dallas, Texas, Verenigde Staten, 95226
        • Baylor Scott & White

Deelname Criteria

Onderzoekers zoeken naar mensen die aan een bepaalde beschrijving voldoen, de zogenaamde geschiktheidscriteria. Enkele voorbeelden van deze criteria zijn iemands algemene gezondheidstoestand of eerdere behandelingen.

Geschiktheidscriteria

Leeftijden die in aanmerking komen voor studie

18 jaar tot 74 jaar (Volwassen, Oudere volwassene)

Accepteert gezonde vrijwilligers

Nee

Geslachten die in aanmerking komen voor studie

Allemaal

Beschrijving

Inclusion Criteria:

  • Non-gated chest CT performed within the prior 2 years within the health system

  • Active health system engagement with an affiliated clinician eligible for notification, defined as ≥1 clinical visit within the prior 2 years AND at least one of the following:

    1. Active enrollment in the site's integrated healthcare plan (e.g., Kaiser Permanente Northern California), OR
    2. LDL-C measured within the health system within the prior 2 years, OR
    3. Outpatient cardiovascular medication prescription within the prior year

  • Meets one of the following clinical criteria:

    1. Clinical ASCVD diagnosis (coronary artery disease, peripheral arterial disease, or ischemic cerebrovascular disease) AND AI-detected CAC >0 on non-gated chest CT, OR
    2. No ASCVD diagnosis AND AI-detected CAC ≥100

  • Suboptimal LDL-C control, defined as either: Last LDL-C ≥70 mg/dL in the last 2 years, OR No LDL-C measurement in the last 2 years

Note: Site-level variations and additional refinements may occur based on local stakeholder input and patient population identification.

Exclusion Criteria:

  • Dementia
  • Heart transplant
  • Active hospice
  • Other life-limiting illness as determined by the site investigator (e.g., metastatic cancer)
  • Additional participant-level exclusions as determined by clinical stakeholders at each site

Studie plan

Dit gedeelte bevat details van het studieplan, inclusief hoe de studie is opgezet en wat de studie meet.

Hoe is de studie opgezet?

Ontwerpdetails

  • Primair doel: Onderzoek naar gezondheidsdiensten
  • Toewijzing: Gerandomiseerd
  • Interventioneel model: Parallelle opdracht
  • Masker: Geen (open label)

Wapens en interventies

Deelnemersgroep / Arm
Interventie / Behandeling
Experimenteel: Early Notification

For participants randomized to notification, the affiliated clinician will receive a message notifying them of the presence of CAC. The notification will include a description of the significance of CAC, provide guideline recommendations, and include a personalized CAC image (as possible). The message will recommend having a risk discussion with the participant. Based on site-level stakeholder feedback, this alert can be retriggered at 2 months for participants who do not have LLT initiation or intensification or LDL-C testing.

Participants will also receive a notification. Based on stakeholder input, this notification can be delivered centrally or from individual clinicians. The notification will include a description of the significance of CAC, a personalized image (as possible), and recommend a risk discussion with their clinician.
Ander: AI-Detected CAC Notification and Care Facilitation

After randomization to the early notification arm, the study team will send a standardized notification message to the participant's affiliated clinician. The study team will send a message to the participant after a brief delay. Each site will determine the timing between the initial message to the clinician and the participant based on stakeholder feedback.

The notification is about the AI-CAC identified on the participant's previous chest CT. It will provide an overview of AI-CAC, a personalized image of AI-CAC, and a recommended risk discussion with their clinician. These clinicians will also be notified of the findings.

For participants randomized to early notification who do not undergo LLT initiation, intensification, or LDL testing within 2 months, the clinician and participant will receive a second message at that time.

The participants in the delayed notification arm will receive a similar notification 6 months later.
Geen tussenkomst: Delayed Notification

Participants will have their CT scans interpreted and reported according to standard clinical practice. This may mention the presence of CAC in the official radiology imaging report, per usual practice. Participants will not receive any notification beyond this standard of care during the 6-month study period.

The study team will send a similar notification as the early notification arm to the participants after completion of the study's primary endpoint assessment.

Wat meet het onderzoek?

Primaire uitkomstmaten

Uitkomstmaat
Maatregel Beschrijving
Tijdsspanne
Lipid-lowering therapy initiation or intensification (LLTI)
Tijdsspanne: 6 months after participant randomization
  • Number of new statin prescriptions
  • Number of statin doses/intensity increase
  • Number of PSCK9 inhibitor initiation (monoclonal antibodies and siRNA)
  • Number of Ezetimibe initiations
  • Number of Bempedoic acid initiations
6 months after participant randomization

Secundaire uitkomstmaten

Uitkomstmaat
Maatregel Beschrijving
Tijdsspanne
Aspirin prescription
Tijdsspanne: 6 months after participant randomization

Number of new Aspirin or other antiplatelet prescription
6 months after participant randomization
Lipid panel (total cholesterol, HDL-C, LDL-C, triglycerides) ordering
Tijdsspanne: 6 months after participant randomization

Number of Lipid panel ordering
6 months after participant randomization
Lipoprotein(a) test ordering
Tijdsspanne: 6 months after participant randomization

Number of Lipoprotein(a) test ordering
6 months after participant randomization
Changes of total cholesterol, HDL-C, LDL-C, triglycerides, Lipoprotein(a) levels
Tijdsspanne: 6 months after participant randomization

This outcome measure the changes of the test levels
6 months after participant randomization
Healthcare resource use
Tijdsspanne: Baseline through Month 6
  • Number of primary care clinical encounters
  • Number of cardiology encounters
  • Number of coronary artery disease-related imaging tests (e.g. noninvasive stress tests, coronary computed tomography angiography (CCTAs), and angiograms)
Baseline through Month 6

Medewerkers en onderzoekers

Hier vindt u mensen en organisaties die betrokken zijn bij dit onderzoek.

Sponsor

Stanford University

Medewerkers

University of California, Los Angeles
Duke University
Vanderbilt University Medical Center
Kaiser Permanente
Amgen
Baylor Scott and White Health

Onderzoekers

  • Hoofdonderzoeker: Fatima Rodriguez, MD, MPH, Stanford University

Studie record data

Deze datums volgen de voortgang van het onderzoeksdossier en de samenvatting van de ingediende resultaten bij ClinicalTrials.gov. Studieverslagen en gerapporteerde resultaten worden beoordeeld door de National Library of Medicine (NLM) om er zeker van te zijn dat ze voldoen aan specifieke kwaliteitscontrolenormen voordat ze op de openbare website worden geplaatst.

Bestudeer belangrijke data

Studie start (Werkelijk)

19 augustus 2026

Primaire voltooiing (Geschat)

1 september 2027

Studie voltooiing (Geschat)

1 maart 2028

Studieregistratiedata

Eerst ingediend

12 januari 2026

Eerst ingediend dat voldeed aan de QC-criteria

12 januari 2026

Eerst geplaatst (Werkelijk)

21 januari 2026

Updates van studierecords

Laatste update geplaatst (Werkelijk)

12 november 2026

Laatste update ingediend die voldeed aan QC-criteria

11 november 2026

Laatst geverifieerd

1 november 2026

Meer informatie

Termen gerelateerd aan deze studie

Aanvullende relevante MeSH-voorwaarden

Andere studie-ID-nummers

  • 84062

Plan Individuele Deelnemersgegevens (IPD)

Bent u van plan om gegevens van individuele deelnemers (IPD) te delen?

NEE

Informatie over medicijnen en apparaten, studiedocumenten

Bestudeert een door de Amerikaanse FDA gereguleerd geneesmiddel

Nee

Bestudeert een door de Amerikaanse FDA gereguleerd apparaatproduct

Nee

product vervaardigd in en geëxporteerd uit de V.S.

Nee

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