Cardiovascular screening in asymptomatic South Asians - a pilot study

  • Research type

    Research Study

  • Full title

    Cardiovascular screening in asymptomatic South Asians – a pilot randomized comparison of Q-risk 3 score versus Computed Tomography Coronary Angiography (CTCA)

  • IRAS ID

    331211

  • Contact name

    Vinoda Sharma

  • Contact email

    vinodasharma@nhs.net

  • Sponsor organisation

    Sandwell and West Birmingham NHS Trust

  • Clinicaltrials.gov Identifier

    NCT06765785

  • Duration of Study in the UK

    2 years, 9 months, 1 days

  • Research summary

    Cardiovascular disease (CVD) is the leading cause of morbidity, mortality and healthcare costs in the United Kingdom. Ethnic minorities like South Asians (SA) have a 3-5 times higher incidence of heart disease despite fewer traditional cardiovascular risk factors.
    Computed Tomography Coronary Angiography (CTCA) is able to determine the site, severity and type of blockage location in the heart arteries. The National Institute for Health and Care Excellence (NICE) guidelines recommends CTCA as the first line for stable chest pain coming from the heart (angina). However there is no pathway for the patients who are asymptomatic but at high risk of CVD, such as the SA cohort. Current practice involves using risk scores to guide management of asymptomatic adults. One recommended and commonly used score is the Q-risk score (the QRISK ® 3-2018 risk calculatorhttps://qrisk.org › three). Patients with a risk ≥10% of having a heart attack or stroke in the next 10 years are offered primary prevention treatment with low dose statin therapy. This risk score underestimates the cardiac risk in the SA population. For example, an average (height 164cm weight 70kg) 40 year old male South Asian, without symptoms who is a non-smoker but with Diabetes Mellitus on tablet treatment scores 5.8% - this risk is not high enough to warrant treatment with a statin unless he also has abnormally raised cholesterol levels. But he continues to be at high risk for heart disease. There is no current evidence to tailor treatment in such asymptomatic, high risk ethnic minorities.
    Similar to screening programs for cancer, we hypothesise that screening CTCA may help in risk stratification for heart disease in SA patients. We aim to randomise 50 asymptomatic South Asian patients with one CV risk factor to either Q-risk 3 score or to screening CTCA.

  • REC name

    East Midlands - Leicester Central Research Ethics Committee

  • REC reference

    25/EM/0029

  • Date of REC Opinion

    13 Mar 2025

  • REC opinion

    Further Information Favourable Opinion