Trial Outcomes & Findings for CT COMPARE: CT Coronary Angiography to Measure Plaque Reduction (NCT NCT02740699)

NCT ID: NCT02740699

Last Updated: 2024-10-09

Results Overview

Mean change of non-calcified plaque volume assessed by Coronary computed tomography angiography in participants treated with high intensity statin therapy (as defined by the 2013 ACC/AHA Guidelines to Reduce Cardiovascular Risk (GRCR). Using anatomical landmarks, a target plaque volume will be defined at baseline and follow up examinations. Software will be used to trace lumen and outer vessel boundaries to determine non-calcified plaque volume. The 2013 ACC/AHA Guidelines to GRCR focuses on the assessment of cardiovascular risk, lifestyle modifications to reduce cardiovascular risk and management of elevated blood cholesterol and body weight in adults. High-intensity statin therapy is defined by: rosuvastatin 20-40 mg or atorvastatin 40-80 mg. The maximum statin dose will be administered that is tolerated by the patient and that maintains LDL-C \> or = 25 mg/dl. High-intensity statin therapy is defined as lowering LDL-C on average by approximately \> or = 50%.

Recruitment status

TERMINATED

Study phase

PHASE4

Target enrollment

79 participants

Primary outcome timeframe

Baseline and 24 months

Results posted on

2024-10-09

Participant Flow

Participant milestones

Participant milestones
Measure
Moderate to High Statin Treatment in Participants With Coronary Artery Plaque
Participants with coronary artery plaque will receive moderate to high statin treatment at either 20-40 mg once daily Rosuvastatin or 40-80 mg once daily of Atorvastatin.
Overall Study
STARTED
79
Overall Study
COMPLETED
55
Overall Study
NOT COMPLETED
24

Reasons for withdrawal

Reasons for withdrawal
Measure
Moderate to High Statin Treatment in Participants With Coronary Artery Plaque
Participants with coronary artery plaque will receive moderate to high statin treatment at either 20-40 mg once daily Rosuvastatin or 40-80 mg once daily of Atorvastatin.
Overall Study
Lost to Follow-up
5
Overall Study
Withdrawal by Subject
14
Overall Study
Physician Decision
5

Baseline Characteristics

CT COMPARE: CT Coronary Angiography to Measure Plaque Reduction

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Moderate to High Statin Treatment in Participants With Coronary Artery Plaque
n=79 Participants
Participants with coronary artery plaque will receive moderate to high statin treatment at either 20-40 mg once daily Rosuvastatin or 40-80 mg once daily of Atorvastatin.
Age, Categorical
<=18 years
0 Participants
n=5 Participants
Age, Categorical
Between 18 and 65 years
30 Participants
n=5 Participants
Age, Categorical
>=65 years
49 Participants
n=5 Participants
Age, Continuous
65.4 years
n=5 Participants
Sex: Female, Male
Female
12 Participants
n=5 Participants
Sex: Female, Male
Male
67 Participants
n=5 Participants
Ethnicity (NIH/OMB)
Hispanic or Latino
1 Participants
n=5 Participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
78 Participants
n=5 Participants
Ethnicity (NIH/OMB)
Unknown or Not Reported
0 Participants
n=5 Participants
Race (NIH/OMB)
American Indian or Alaska Native
1 Participants
n=5 Participants
Race (NIH/OMB)
Asian
2 Participants
n=5 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants
n=5 Participants
Race (NIH/OMB)
Black or African American
3 Participants
n=5 Participants
Race (NIH/OMB)
White
72 Participants
n=5 Participants
Race (NIH/OMB)
More than one race
0 Participants
n=5 Participants
Race (NIH/OMB)
Unknown or Not Reported
1 Participants
n=5 Participants
Region of Enrollment
United States
79 participants
n=5 Participants

PRIMARY outcome

Timeframe: Baseline and 24 months

Population: Intention to treat analysis for those participants with observed plaque volumes by Coronary artery CT angiography at baseline and 24 months will be included in the primary analysis.

Mean change of non-calcified plaque volume assessed by Coronary computed tomography angiography in participants treated with high intensity statin therapy (as defined by the 2013 ACC/AHA Guidelines to Reduce Cardiovascular Risk (GRCR). Using anatomical landmarks, a target plaque volume will be defined at baseline and follow up examinations. Software will be used to trace lumen and outer vessel boundaries to determine non-calcified plaque volume. The 2013 ACC/AHA Guidelines to GRCR focuses on the assessment of cardiovascular risk, lifestyle modifications to reduce cardiovascular risk and management of elevated blood cholesterol and body weight in adults. High-intensity statin therapy is defined by: rosuvastatin 20-40 mg or atorvastatin 40-80 mg. The maximum statin dose will be administered that is tolerated by the patient and that maintains LDL-C \> or = 25 mg/dl. High-intensity statin therapy is defined as lowering LDL-C on average by approximately \> or = 50%.

Outcome measures

Outcome measures
Measure
Moderate to High Statin Treatment in Participants With Coronary Artery Plaque
n=55 Participants
Participants with coronary artery plaque will receive moderate to high statin treatment at either 20-40 mg once daily Rosuvastatin or 40-80 mg once daily of Atorvastatin.
Mean Change of Non-calcified Plaque Volume in Participants Treated With High Intensity Statin Therapy Assessed by Coronary Computed Tomography Angiography
23.3 mm^3
Standard Deviation 76.6

SECONDARY outcome

Timeframe: Baseline and 36 months

Population: Intention to treat for those participants with observed plaque volumes by Coronary artery CT angiography at baseline and 36 months will be included in the secondary analysis.

Mean change of non-calcified plaque volume assessed by Coronary computed tomography angiography in participants treated with high intensity statin therapy (as defined by the 2013 ACC/AHA Guidelines to Reduce Cardiovascular Risk (GRCR). Using anatomical landmarks, a target plaque volume will be defined at baseline and follow up examinations. Software will be used to trace lumen and outer vessel boundaries to determine non-calcified plaque volume. The 2013 ACC/AHA Guidelines to GRCR focuses on the assessment of cardiovascular risk, lifestyle modifications to reduce cardiovascular risk and management of elevated blood cholesterol and body weight in adults. High-intensity statin therapy is defined by: rosuvastatin 20-40 mg or atorvastatin 40-80 mg. The maximum statin dose will be administered that is tolerated by the patient and that maintains LDL-C \> or = 25 mg/dl. High-intensity statin therapy is defined as lowering LDL-C on average by approximately \> or = 50%.

Outcome measures

Outcome measures
Measure
Moderate to High Statin Treatment in Participants With Coronary Artery Plaque
n=52 Participants
Participants with coronary artery plaque will receive moderate to high statin treatment at either 20-40 mg once daily Rosuvastatin or 40-80 mg once daily of Atorvastatin.
Mean Change of Non-calcified Plaque Volume in Participants Treated With High Intensity Statin Therapy Assessed by Coronary Computed Tomography Angiography
8.86 mm^3
Standard Deviation 75.3

SECONDARY outcome

Timeframe: Baseline, 24 months and 36 months

Population: Intention to treat for those participants with observed plaque volumes by Coronary artery CT angiography at baseline, 24 months and 36 months will be included in the secondary analysis.

Linear mixed-effects regression coefficient of age effect on plaque volume measured by Coronary artery CT angiography. Plaque volumes (mm3) were quantified from coronary CTA exams using a validated automated method developed by Cleerly. Regression coefficient is the mean change of plaque volume given one year increase of age. In the mixed-effects model the outcomes are plaque volumes measured at Baseline, 24 months and 36 months as described in 2011 "Applied Longitudinal Analysis" Wiley Series in Probability and Statistics by Fitzmaurice, Laird, and Ware.

Outcome measures

Outcome measures
Measure
Moderate to High Statin Treatment in Participants With Coronary Artery Plaque
n=52 Participants
Participants with coronary artery plaque will receive moderate to high statin treatment at either 20-40 mg once daily Rosuvastatin or 40-80 mg once daily of Atorvastatin.
Linear Mixed-effects Regression Coefficient of Age Effect on Plaque Volume
1.48 mm^3/year
Standard Deviation 2.65

SECONDARY outcome

Timeframe: Baseline, 24 months and 36 months

Population: Intention to treat for those participants with observed plaque volumes by Coronary artery CT angiography at baseline, 24 months and 36 months will be included in the secondary analysis.

Linear Mixed-effects Regression Coefficient of sex (female = 0 and male = 1) effect on plaque volume measured by Coronary artery CT angiography (beta coefficient). Plaque volumes (mm3) were quantified from coronary CTA exams using a validated automated method developed by Cleerly. Regression coefficient is the mean change of plaque volume comparing male verses female (female =0 and male = 1). In the mixed-effects model the outcomes are plaque volumes measured at Baseline, 24 months and 36 months as described in 2011 "Applied Longitudinal Analysis" Wiley Series in Probability and Statistics by Fitzmaurice, Laird, and Ware.

Outcome measures

Outcome measures
Measure
Moderate to High Statin Treatment in Participants With Coronary Artery Plaque
n=52 Participants
Participants with coronary artery plaque will receive moderate to high statin treatment at either 20-40 mg once daily Rosuvastatin or 40-80 mg once daily of Atorvastatin.
Linear Mixed-Effects Regression Coefficient of Sex Effect on Plaque Volume (Beta Coefficient)
100.58 beta coefficient [mm^3]
Standard Deviation 51.99

SECONDARY outcome

Timeframe: Baseline, 24 months and 36 months

Population: Intention to treat for those participants with observed plaque volumes by Coronary artery CT angiography at baseline, 24 months and 36 months will be included in the secondary analysis.

Linear Mixed-effects Regression Coefficient of Effects race (white = 1 and non-white = 0) effect on plaque volume measured by Coronary artery CT angiography. Plaque volumes (mm3) were quantified from coronary CTA exams using a validated automated method developed by Cleerly. Regression coefficient is the mean change of plaque volume comparing race (white = 1 and non-white = 0). In the mixed-effects model the outcomes are plaque volumes measured at Baseline, 24 months and 36 months as described in 2011 "Applied Longitudinal Analysis" Wiley Series in Probability and Statistics by Fitzmaurice, Laird, and Ware.

Outcome measures

Outcome measures
Measure
Moderate to High Statin Treatment in Participants With Coronary Artery Plaque
n=52 Participants
Participants with coronary artery plaque will receive moderate to high statin treatment at either 20-40 mg once daily Rosuvastatin or 40-80 mg once daily of Atorvastatin.
Linear Mixed-effects Regression Coefficient of Race Effect on Plaque Volume (Beta Coefficient)
35.66 Beta coefficient [mm^3]
Standard Deviation 859.39

SECONDARY outcome

Timeframe: Baseline, 24 months and 36 months

Population: Intention to treat for those participants with observed plaque volumes by Coronary artery CT angiography at baseline, 24 months and 36 months will be included in the secondary analysis.

Linear Mixed-effects Regression Coefficient of Body Mass Index Effect on Plaque Volume measured by Coronary artery CT angiography. Plaque volumes (mm3) were quantified from coronary CTA exams using a validated automated method developed by Cleerly. Regression coefficient is the mean change of plaque volume given one kg/m\^2 increase of BMI. In the mixed-effects model the outcomes are plaque volumes measured at Baseline, 24 months and 36 months as described in 2011 "Applied Longitudinal Analysis" Wiley Series in Probability and Statistics by Fitzmaurice, Laird, and Ware.

Outcome measures

Outcome measures
Measure
Moderate to High Statin Treatment in Participants With Coronary Artery Plaque
n=52 Participants
Participants with coronary artery plaque will receive moderate to high statin treatment at either 20-40 mg once daily Rosuvastatin or 40-80 mg once daily of Atorvastatin.
Linear Mixed-effects Regression Coefficient of Body Mass Index Effect on Plaque Volume
7.65 mm^3/[kg/m^2]
Standard Deviation 2.68

Adverse Events

Moderate to High Statin Treatment in Participants With Coronary Artery Plaque

Serious events: 8 serious events
Other events: 56 other events
Deaths: 0 deaths

Serious adverse events

Serious adverse events
Measure
Moderate to High Statin Treatment in Participants With Coronary Artery Plaque
n=79 participants at risk
Participants with coronary artery plaque will receive moderate to high statin treatment at either 20-40 mg once daily Rosuvastatin or 40-80 mg once daily of Atorvastatin.
Musculoskeletal and connective tissue disorders
Arthritis
1.3%
1/79 • Number of events 1 • Up to 36 months
Cardiac disorders
Coronary stent placement
1.3%
1/79 • Number of events 1 • Up to 36 months
Nervous system disorders
Dizziness
1.3%
1/79 • Number of events 1 • Up to 36 months
Nervous system disorders
Seizure
1.3%
1/79 • Number of events 1 • Up to 36 months
Injury, poisoning and procedural complications
Fracture
1.3%
1/79 • Number of events 1 • Up to 36 months
Gastrointestinal disorders
Small intestinal obstruction
1.3%
1/79 • Number of events 1 • Up to 36 months
Surgical and medical procedures
Knee replacement
1.3%
1/79 • Number of events 1 • Up to 36 months
Vascular disorders
Subaraschnoid hemorrhage
1.3%
1/79 • Number of events 1 • Up to 36 months

Other adverse events

Other adverse events
Measure
Moderate to High Statin Treatment in Participants With Coronary Artery Plaque
n=79 participants at risk
Participants with coronary artery plaque will receive moderate to high statin treatment at either 20-40 mg once daily Rosuvastatin or 40-80 mg once daily of Atorvastatin.
Blood and lymphatic system disorders
Anemia
8.9%
7/79 • Number of events 7 • Up to 36 months
Blood and lymphatic system disorders
Chronic lymphocytic leukemia
1.3%
1/79 • Number of events 1 • Up to 36 months
Blood and lymphatic system disorders
Varicosities
1.3%
1/79 • Number of events 1 • Up to 36 months
Cardiac disorders
Acute coronary syndrome
1.3%
1/79 • Number of events 1 • Up to 36 months
Cardiac disorders
Systolic murmur
1.3%
1/79 • Number of events 1 • Up to 36 months
Cardiac disorders
Sick sinus syndrome
1.3%
1/79 • Number of events 1 • Up to 36 months
Cardiac disorders
Sinus bradycardia
8.9%
7/79 • Number of events 9 • Up to 36 months
Cardiac disorders
Sinus tachycardia
1.3%
1/79 • Number of events 1 • Up to 36 months
Ear and labyrinth disorders
Vertigo
1.3%
1/79 • Number of events 1 • Up to 36 months
Endocrine disorders
Hypothyroidism
1.3%
1/79 • Number of events 1 • Up to 36 months
Gastrointestinal disorders
Abdominal infection
1.3%
1/79 • Number of events 1 • Up to 36 months
Gastrointestinal disorders
Bloating
2.5%
2/79 • Number of events 2 • Up to 36 months
Gastrointestinal disorders
Diarrhea
1.3%
1/79 • Number of events 1 • Up to 36 months
Gastrointestinal disorders
Gastroesophageal reflux disease
3.8%
3/79 • Number of events 3 • Up to 36 months
Gastrointestinal disorders
Nausea
3.8%
3/79 • Number of events 3 • Up to 36 months
General disorders
Edema limbs
5.1%
4/79 • Number of events 4 • Up to 36 months
General disorders
Fatigue
2.5%
2/79 • Number of events 3 • Up to 36 months
General disorders
Flu like symptoms
1.3%
1/79 • Number of events 1 • Up to 36 months
General disorders
Shoulder pain
1.3%
1/79 • Number of events 1 • Up to 36 months
General disorders
Malaise
2.5%
2/79 • Number of events 2 • Up to 36 months
Infections and infestations
H.pylori
1.3%
1/79 • Number of events 1 • Up to 36 months
Infections and infestations
Lip infection
1.3%
1/79 • Number of events 1 • Up to 36 months
Injury, poisoning and procedural complications
Fall
2.5%
2/79 • Number of events 2 • Up to 36 months
Investigations
Alanine aminotransferase increased
12.7%
10/79 • Number of events 16 • Up to 36 months
Investigations
Alkaline phosphatase increased
1.3%
1/79 • Number of events 1 • Up to 36 months
Investigations
Aspartate aminotransferase increased
13.9%
11/79 • Number of events 14 • Up to 36 months
Investigations
Blood bilirubin increased
3.8%
3/79 • Number of events 5 • Up to 36 months
Investigations
CPK increased
3.8%
3/79 • Number of events 3 • Up to 36 months
Investigations
Cholesterol high
3.8%
3/79 • Number of events 3 • Up to 36 months
Investigations
Creatinine increased
10.1%
8/79 • Number of events 12 • Up to 36 months
Investigations
Hyperkalemia
6.3%
5/79 • Number of events 7 • Up to 36 months
Investigations
Hypertriglyceridemia
10.1%
8/79 • Number of events 14 • Up to 36 months
Investigations
Hyponatremia
6.3%
5/79 • Number of events 7 • Up to 36 months
Investigations
Hemoglobin A1C increased
1.3%
1/79 • Number of events 1 • Up to 36 months
Investigations
LDL decreased
7.6%
6/79 • Number of events 7 • Up to 36 months
Investigations
Lymphocyte count decreased
10.1%
8/79 • Number of events 8 • Up to 36 months
Investigations
Lymphocyte count increased
1.3%
1/79 • Number of events 1 • Up to 36 months
Investigations
Platelet count decreased
6.3%
5/79 • Number of events 5 • Up to 36 months
Investigations
Weight gain
1.3%
1/79 • Number of events 1 • Up to 36 months
Investigations
Weight loss
2.5%
2/79 • Number of events 3 • Up to 36 months
Investigations
White blood cell decreased
2.5%
2/79 • Number of events 2 • Up to 36 months
Metabolism and nutrition disorders
Dehydration
1.3%
1/79 • Number of events 1 • Up to 36 months
Metabolism and nutrition disorders
Glucose intolerance
1.3%
1/79 • Number of events 1 • Up to 36 months
Metabolism and nutrition disorders
Hypercalcemia
1.3%
1/79 • Number of events 2 • Up to 36 months
Metabolism and nutrition disorders
Hyperglycemia
21.5%
17/79 • Number of events 17 • Up to 36 months
Metabolism and nutrition disorders
Hyperkalemia
6.3%
5/79 • Number of events 7 • Up to 36 months
Metabolism and nutrition disorders
Hypermagnesemia
1.3%
1/79 • Number of events 1 • Up to 36 months
Metabolism and nutrition disorders
Hypernatremia
1.3%
1/79 • Number of events 1 • Up to 36 months
Metabolism and nutrition disorders
Hypertriglyceridemia
10.1%
8/79 • Number of events 14 • Up to 36 months
Metabolism and nutrition disorders
Hypoglycemia
1.3%
1/79 • Number of events 1 • Up to 36 months
Metabolism and nutrition disorders
Hypokalemia
1.3%
1/79 • Number of events 1 • Up to 36 months
Metabolism and nutrition disorders
Hyponatremia
6.3%
5/79 • Number of events 7 • Up to 36 months
Musculoskeletal and connective tissue disorders
Arthralgia
3.8%
3/79 • Number of events 3 • Up to 36 months
Musculoskeletal and connective tissue disorders
Back pain
1.3%
1/79 • Number of events 1 • Up to 36 months
Musculoskeletal and connective tissue disorders
Gout attack
1.3%
1/79 • Number of events 1 • Up to 36 months
Musculoskeletal and connective tissue disorders
Prostatitis attack
1.3%
1/79 • Number of events 1 • Up to 36 months
Musculoskeletal and connective tissue disorders
Right Iliotibial band syndrome
1.3%
1/79 • Number of events 1 • Up to 36 months
Musculoskeletal and connective tissue disorders
Degenerative disc disease
1.3%
1/79 • Number of events 1 • Up to 36 months
Musculoskeletal and connective tissue disorders
Myalgia
7.6%
6/79 • Number of events 6 • Up to 36 months
Musculoskeletal and connective tissue disorders
Neck pain
1.3%
1/79 • Number of events 1 • Up to 36 months
Musculoskeletal and connective tissue disorders
Osteoporosis
1.3%
1/79 • Number of events 1 • Up to 36 months
Musculoskeletal and connective tissue disorders
Pain in extremity
2.5%
2/79 • Number of events 2 • Up to 36 months
Neoplasms benign, malignant and unspecified (incl cysts and polyps)
Breast cancer
1.3%
1/79 • Number of events 1 • Up to 36 months
Neoplasms benign, malignant and unspecified (incl cysts and polyps)
Lung nodule
1.3%
1/79 • Number of events 1 • Up to 36 months
Neoplasms benign, malignant and unspecified (incl cysts and polyps)
Nodule
1.3%
1/79 • Number of events 1 • Up to 36 months
Neoplasms benign, malignant and unspecified (incl cysts and polyps)
Nodule in Right Lower Lobe
1.3%
1/79 • Number of events 1 • Up to 36 months
Nervous system disorders
Dizziness
2.5%
2/79 • Number of events 2 • Up to 36 months
Nervous system disorders
Concussion
1.3%
1/79 • Number of events 1 • Up to 36 months
Psychiatric disorders
Depression
1.3%
1/79 • Number of events 1 • Up to 36 months
Renal and urinary disorders
Chronic kidney disease
1.3%
1/79 • Number of events 1 • Up to 36 months
Renal and urinary disorders
Foaming urine
1.3%
1/79 • Number of events 1 • Up to 36 months
Renal and urinary disorders
Stage III Chronic kidney disease
1.3%
1/79 • Number of events 1 • Up to 36 months
Reproductive system and breast disorders
Erectile dysfunction
1.3%
1/79 • Number of events 1 • Up to 36 months
Respiratory, thoracic and mediastinal disorders
Cough
3.8%
3/79 • Number of events 3 • Up to 36 months
Skin and subcutaneous tissue disorders
Alopecia
1.3%
1/79 • Number of events 1 • Up to 36 months
Skin and subcutaneous tissue disorders
Rash acneiform
1.3%
1/79 • Number of events 1 • Up to 36 months
Skin and subcutaneous tissue disorders
Erythematous plaque and patches
1.3%
1/79 • Number of events 1 • Up to 36 months
Surgical and medical procedures
Hip replacement
1.3%
1/79 • Number of events 1 • Up to 36 months
Vascular disorders
Hot flashes
1.3%
1/79 • Number of events 3 • Up to 36 months
Vascular disorders
Hypertension
17.7%
14/79 • Number of events 18 • Up to 36 months
Vascular disorders
Hypotension
1.3%
1/79 • Number of events 1 • Up to 36 months

Additional Information

Dr. Marcus Chen

National Heart, Lung, and Blood Institute at the National Institutes of Health

Phone: 301.496.0077

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place