Reported by ScienceDaily
A major clinical trial has raised new questions about how doctors decide who should take statins to prevent heart attacks and strokes. Researchers found that using heart scans to guide treatment decisions produced the same observed rate of major cardiovascular events as traditional risk assessments, even though the scans led to far fewer recommendations to begin taking statins.
The findings, presented during a Hot Line session at ESC Congress 2026, also revealed a striking difference in how consistently patients took their medication. Those advised to use statins based on calcium buildup in their coronary arteries were substantially more likely to follow their treatment recommendations.
Although the results suggest that heart scans could help doctors make more targeted treatment decisions, the trial did not establish that the scan approach was as effective as conventional risk assessment. Researchers say additional studies are needed to determine whether it offers a better strategy for preventing cardiovascular disease.
More from the original report
Cardiovascular disease remains the world's leading cause of illness and death. Much of this burden comes from atherosclerotic cardiovascular disease (ASCVD), which develops when fatty deposits known as plaque accumulate inside arteries, restricting blood flow and increasing the risk of heart attacks and strokes. Coronary artery disease and ischemic stroke are two major forms of this condition.
Several common factors increase the likelihood of developing ASCVD, including smoking, diabetes, high blood pressure, and elevated cholesterol. Doctors use these factors to estimate a person's cardiovascular risk and determine whether preventive medications are appropriate.
Statins are among the most widely used treatments for lowering that risk. These medications reduce cholesterol levels, particularly low-density lipoprotein cholesterol, often called LDL or bad cholesterol. They also help lower the likelihood of serious cardiovascular complications.
However, identifying which patients stand to benefit from statins remains a significant challenge. Some people who eventually experience a heart attack do not appear to be at particularly high risk under conventional screening methods.
"For far too many patients, the first symptom of ASCVD is a heart attack," said Doctor Joseph B Muhlestein from the Intermountain Medical Center, Murray, USA, the Principal Investigator of the CorCal Outcomes trial.…