Statin trial finds calcium scans did not beat risk-score guidance

Who really needs a statin? The CorCal Outcomes trial, presented as an ESC Congress 2026 Hot Line, randomised 5,772 adults from Intermountain Health in the USA who had no prior cardiovascular disease, diabetes or statin use. One group received guidance based on standard risk equations, the other on coronary artery calcium scans.

After a mean 4.2 years, major adverse cardiovascular events occurred in 2.7 percent of both groups, with a hazard ratio of 0.99. The calcium-scan approach did not demonstrate non-inferiority. Statin recommendations were more than three times as frequent in the risk-score arm, yet adherence was 62 percent in the scan arm versus 23 percent.

That adherence gap is striking, because people who see a personal scan may be more willing to take the pills. Researchers say results should guide future prevention strategies rather than change care overnight. Have you ever discussed a calcium scan with your doctor? Share what helped you understand your own heart risk.