In 5,772 adults, calcium scans and usual risk scores had the same observed rate of major heart events, and the scan arm was not shown to be noninferior

What the research found

ScienceDaily published this account on 6 November 2026 from a Hot Line presentation at ESC Congress 2026. Joseph B. Muhlestein and colleagues at Intermountain ran the CorCal Outcomes trial. They enrolled 5,772 adults with no known atherosclerotic cardiovascular disease, no diabetes, and no prior statin. Mean age was 64, and 51 percent were women. People were randomized 1 to 1. One arm used the pooled cohort equations. The other used a coronary artery calcium scan. Patients and clinicians were told the study recommendation. The choice to start a statin stayed with them. Over a mean of 4.2 years, 2.7 percent of each group had a major event (death from any cause, heart attack, stroke, or a procedure to open an artery). The hazard ratio was 0.99 (95 percent CI 0.71 to 1.38). A noninferiority test was reported at p=0.045, and the investigators still say they did not show the scan strategy was noninferior, because fewer events occurred than planned. Risk-score guidance recommended a statin more than three times as often. Among people advised to take one, 62 percent in the scan arm and 23 percent in the risk-score arm kept taking it. The account does not explain that gap. This is a conference report of a decision trial, not proof that a calcium scan can replace usual risk scoring. Statin choices stay with a clinician. Not medical advice.

Evidence level: Clinical trial. This is among the stronger kinds of evidence, but one study rarely settles a question.

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