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Coronary Artery DiseasePhase 4ARTCAPNCT06280976

Aggressive Risk-Prevention Therapies for Coronary Atherosclerotic Plaque (ART-CAP)

A Phase 4 study testing Statin, Aspirin tablet and Nexlizet in people with Coronary Artery Disease and Atherosclerosis, run by University of Louisville at 1 site in United States.

Withdrawn

Withdrawn. The study stopped before anyone enrolled.

Official record
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Trial summary

The purpose of this study is to evaluate the role of coronary CT angiogram (CCTA) as a superior guide for the assessment of coronary artery plaque and guiding treatment decisions. The investigators also assess the impact of preventive cardiovascular drugs on the plaque to improve patient outcomes. Read more about this study

Who is it for?
Ages 18 to 80 years
What is being tested?
Statin, Aspirin tablet and Nexlizet
Type of treatment
Pill or oral medicine
Could I receive a placebo?
No, everyone receives an active treatment
How many people
0 participants
Where
1 siteUnited States
Study dates
1 Mar 2024to 1 Jan 2025
Phase
Phase 4
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 to 80 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Non-obstructive atherosclerotic coronary artery plaque (stenosis of 0-39% or stenosis of 40-69% with FFR-CT >0.8) in a major epicardial vessel > 2 mm in diameter.

Who cannot join

  • coronary/PAD/carotid revascularization or ischemic stroke or TIA within 6 months prior to enrollment
  • Valvular heart disease of moderate or worse severity or requiring interventional procedures or surgery
  • LVEF <35% in the past 12 months
  • Pulmonary hypertension with PASP>50 mm Hg in the past 12 months
  • Myocarditis or pericarditis in the past 12 months
  • Known Cardiomyopathy (hypertrophic, infiltrative, restrictive, dilated, etc.)
Show all 20Show fewer
  • Heart failure NYHA class 3 or 4
  • Hospitalization for heart failure in the preceding 6 months
  • Life expectancy of <1 year
  • An organ-transplant recipient or if felt to require listing for solid organ transplantation during study status
  • Inability to give informed consent
  • Active malignancy (except basal cell skin cancer)
  • Cirrhosis
  • ESRD
  • Pregnancy or planning to conceive during the study period
  • Known intolerance or perceived contraindication to any of the study drugs during the study period including statins or aspirin if indicated
  • eGFR<30 ml/min/m2
  • Inability to receive iodinated contrast for CCTA
  • Chronic immunosuppression therapy
  • Uncontrolled psychiatric illness

Trial locations and contacts

1 site in 1 country.

United States1 site
  • University of Louisville School of Medicine, Division of Cardiovascular Diseases

    Louisville, Kentucky, 40202

Other trials in United States

About this study

The purpose of this study is to evaluate the role of coronary CT angiogram (CCTA) as a superior guide for the assessment of coronary artery plaque and guiding treatment decisions. The investigators also assess the impact of preventive cardiovascular drugs on the plaque to improve patient outcomes. Participants aged 18-80 years, at intermediate or high-risk for coronary artery disease, with non-obstructive plaque on initial CCTA, will be enrolled in this study. They will be randomized into Standard of Care (SOC) vs. Aggressive Therapy (AT) groups. Both groups will undergo dietary and lifestyle interventions. Follow-up will consist of blood tests and clinic visits at baseline, 9 months, and 18 months. The second CCTA will be performed at 18 months to assess the change in plaque burden, characteristics, ischemia and pericoronary/epicardial fat.

Read the detailed description

ART-CAP (Aggressive Risk-Prevention Therapies for Coronary Atherosclerotic Plaque ) is a prospective randomized open-label trial with blinded end-point. This research project aims to study the role of coronary computed tomographic angiography (CCTA) as a superior guide for the direct assessment and monitoring of the impact of preventive cardiovascular drugs on coronary artery plaque for better clinical decision-making and improving patient outcomes. Participants aged 18-80 years, at intermediate or high-risk (10-year ASCVD risk of 5-20% or >20%; calculated based on age, gender, race, history of smoking, diabetes mellitus, hypertension, hyperlipidemia, and family history of premature CAD, with/without symptoms suggestive of coronary disease) who has non-obstructive plaque on CCTA (stenosis of 0-39% or 40-69% with FFR-CT >0.8), will be enrolled. Participants with a history of heart attack, coronary stents or bypass surgery, recent stroke, severe valvular heart disease, pulmonary hypertension, NYHA class 3 or 4 heart failure, recent heart failure hospitalization, active cancer, life expectancy of <1 year, end-stage kidney or liver disease, pregnancy or uncontrolled psychiatric illness, will be excluded.

Participants will be randomly assigned to two groups - Standard of Care (SOC, 100 pts) vs. Aggressive Therapy (AT, 100 pts). Both groups will receive dietary and lifestyle interventions. SOC will be treated with statin and/or aspirin as per the ACC guidelines. AT group will be treated with statin, aspirin, nexlizet, leqvio, vascepa, jardiance, and colchicine. Follow-up will consist of blood tests and clinic visits at baseline, 9 months, and 18 months. At baseline, participants will undergo Polygenic Risk Score (PRS) and next-generation sequencing (NGS) for a South Asian gene panel. Biomarker evaluations at baseline, 9 months, and 18 months include lipid profiles, inflammatory markers, cardiac biomarkers, and buffy coat analysis for CHIP, along with standard blood tests including CBC and CMP. Additionally, echocardiographic evaluation will be performed at baseline and 18 months.

After 18 months of medical treatment, a repeat CCTA will be performed to evaluate primary endpoints of the percentage change in plaque burden (total, non-calcified and calcified), plaque characteristics including high-risk features, ischemia value for the most severe lesion, and pericoronary/epicardial fat attenuation. Patient will be followed for additional 5 years for MACCE (major adverse cardiovascular and cerebrovascular events).

Being tested
Statin, Aspirin tablet, Nexlizet, LEQVIO, Vascepa
Keywords
Coronary artery plaque, Coronary CT angiogram
Medical subject headings
Coronary Artery Disease, Atherosclerosis, Myocardial Infarction

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • StatinDrug

    Also called atorvastatin

    high intensity statin (eg atorvastatin 80 mg daily)

  • Aspirin tabletDrug

    Also called aspirin 81 mg

    aspirin 81 mg po qd

  • NexlizetDrug

    Also called bempedoic acid-ezetimibe

    bempedoic acid-ezetimibe 180-10 mg po qd

  • LEQVIODrug

    Also called inclisiran

    inclisiran SQ as per product insert

  • VascepaDrug

    Also called icosapent ethyl

    icosapent ethyl 2g PO BID

  • JardianceDrug

    Also called empagliflozin

    empagliflozin 10 mg PO QD

  • ColchicineDrug

    Colchicine 0.5 MG po qd

Study groups in NCT06280976
Study groupRoleWhat they receive
SOC: Statin ± Aspirin (per ACC guidelines)Active comparatorThe SOC group: participant receive routine care as per cardiologist. Study doctor will prescribe medications that they choose themselves.
Receives: Drug: Statin; Drug: Aspirin tablet
AT: Statin, Aspirin, Nexlizet, Leqvio, Vascepa, Jardiance, ColchicineExperimentalAn AT group: FDA-approved drugs will be used to reduce cholesterol and cardiovascular risk.
Receives: Drug: Statin; Drug: Aspirin tablet; Drug: Nexlizet; Drug: LEQVIO; Drug: Vascepa; Drug: Jardiance; Drug: Colchicine

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Plaque quantification

    Quantification of plaque including total plaque, calcified plaque, non-calcified plaque, and partially calcified plaque. Units: mm3

    Measured: Baseline, 18 months

  2. Characterization of plaque to evaluate for high-risk features - positive remodeling

    Characterization of plaque to evaluate for high-risk features - positive remodeling Units: no units (yes or no)

    Measured: Baseline, 18 months

  3. Quantification of stenosis

    Quantification of stenosis by using CT-FFR. Unit: percentage

    Measured: Baseline, 18 months

  4. Quantification of pericoronary fat attenuation.

    Quantification of pericoronary and epicardial fat attenuation. Unit: Fat attenuation index [ranging from -190 to -30 Hounsfield units (HU)]

    Measured: Baseline, 18 months

  5. Characterization of plaque to evaluate for high-risk features - low CT attenuation

    Characterization of plaque to evaluate for high-risk features - low CT attenuation Units: no units (yes or no)

    Measured: Baseline, 18 months

  6. Characterization of plaque to evaluate for high-risk features - napkin-ring sign

    Characterization of plaque to evaluate for high-risk features - napkin-ring sign Units: no units (yes or no)

    Measured: Baseline, 18 months

  7. Quantification of epicardial fat attenuation.

    Quantification of epicardial fat attenuation. Unit: Fat attenuation index [ranging from -190 to -30 Hounsfield units (HU)]

    Measured: Baseline, 18 months

Secondary outcomes (13)
  1. Major adverse cardiac and cardiovascular events (MACCE)

    Number of participants with adjusted events including non-fatal myocardial infarction, stroke, transient ischemic attack, urgent revascularization, cardiovascular hospitalization, hospitalization for heart failure, and cardiovascular death.

    Unit: number of events

    Measured: 5 years

  2. Polygenic risk score (PRS)

    Polygenic risk score (PRS) to estimate the participant's genetic susceptibility for coronary artery disease, assessed via blood draw.

    Unit: No units (weighted score ranging from 0-100)

    Measured: Baseline

  3. Next generation sequencing (NGS)

    Next generation sequencing (NGS) to identify mutations associated with coronary artery disease, assessed via blood draw.

    Unit: Mutation in disease-genes

    Measured: Baseline

  4. Change in Lipoprotein (a)

    Change in Lipoprotein (a) level as assessed via blood draw. Unit: nmol/L

    Measured: Baseline, 9 and 18 months

  5. Change in myeloperoxidase (MPO) activity

    Change in myeloperoxidase (MPO) activity, as assessed via blood draw. Unit: μU/mg

    Measured: Baseline, 9 and 18 months

  6. Change in trimethylamine-N-oxide (TMAO) levels

    Change in trimethylamine-N-oxide (TMAO) levels, assessed via blood draw. Unit: µM

    Measured: Baseline, 9 and 18 months

  7. Change in lipoprotein-associated phospholipase A2 (Lp-PLA2) levels

    Change in lipoprotein-associated phospholipase A2 (Lp-PLA2) levels, as assessed by blood draw.

    Unit: ng/mL

    Measured: Baseline, 9 and 18 months

  8. Change in interleukin-6 (IL-6) levels

    Change in interleukin-6 (IL-6) levels, as assessed by blood draw. Unit: pg/mL

    Measured: Baseline, 9 and 18 months

  9. Change in high sensitivity C-creative protein (HS-CRP) levels

    Change in high sensitivity C-creative protein (HS-CRP) levels as assessed by blood draw.

    Units: mg/mL

    Measured: Baseline, 9 and 18 months

  10. Buffy coat for chromatin immunoprecipitation (ChIP)

    Buffy coat for chromatin immunoprecipitation (ChIP) as assessed by blood draw. Unit: Genomic locations of binding of various proteins involved in coronary plaque formation

    Measured: Baseline, 9 and 18 months

  11. Change in high sensitivity Troponin (HS-Tn)

    Change in high sensitivity Troponin (HS-Tn), as assessed by blood draw. Unit: ng/mL

    Measured: Baseline, 9 and 18 months

  12. Change in natriuretic peptide (BNP, NT-pro BNP

    Change in natriuretic peptide (BNP, NT-pro BNP), as assessed by blood draw. Unit: pg/mL

    Measured: Baseline, 9 and 18 months

  13. Change in levels of open reading frame 1 protein (ORF1p)

    Change in levels of open reading frame 1 protein (ORF1p), as assessed by blood draw using enzyme-linked immunosorbent assay (ELISA) or western blotting.

    Unit: μg/mL

    Measured: Baseline, 9 and 18 months

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted28 Feb 2024
  2. Study start1 Mar 2024
  3. Primary completion1 Jan 2025
  4. Study completion1 Jan 2025

Why it stopped: study withdrawn, no participants enrolled, changes in the study design planned

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 4
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Model description
PROBE design: Prospective Randomized Open Label Blinded End-point
Masking
None (open label)
Enrolment
0 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT06280976
Sponsor's protocol ID
23.0001
Acronym
ARTCAP
Status last verified
Apr 2024
First submitted
5 Feb 2024
Last updated
17 Mar 2025
Results posted
No
Data monitoring committee
No
FDA-regulated drug
Yes
FDA-regulated device
No
Individual data sharing
No

Questions about this trial

What is this clinical trial studying?

A Phase 4 study testing Statin, Aspirin tablet and Nexlizet in people with Coronary Artery Disease and Atherosclerosis, run by University of Louisville at 1 site in United States.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 1 inclusion and 20 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: withdrawn, as of the sponsor's last update on 17 Mar 2025. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in United States. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 4 studies take place after a treatment is approved, to learn more about its long-term benefits and risks in everyday use.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

The study was withdrawn before enrolling participants, so there are no results.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Plaque quantification (time frame: Baseline, 18 months). The study lists 7 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 17 Mar 2025; AzTrials last refreshed its copy on 7 Nov 2026.

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