Picture of Incidental Calcium To Understand Risk Estimate (PICTURE) Trial

Trial ID or NCT#



recruiting iconRECRUITING


This is a prospective randomized controlled trial assessing the impact of notifying patients and their clinicians of an incidental finding of coronary artery calcification (CAC) indicating increased cardiovascular risk. Patients will be identified through completed radiology orders for non-gated, non-contrast chest CT in the appropriate clinical context and then will have an EHR screen for inclusion criteria. The presence of CAC will be confirmed by a board-certified physician. Eligible patients will be randomized to CAC notification or usual care using a 1:1 stratified block randomization method based on baseline statin use.

Official Title

NOTIFY 2: Picture of Incidental Calcium To Understand Risk Estimate

Eligibility Criteria

Ages Eligible for Study: 18 Years to 84 Years
Sexes Eligible for Study: All
Accepts Healthy Volunteers: No
Inclusion Criteria:
  1. - Age 18 and above and <85 - Non-gated chest CT with CAC - An encounter after January 1, 2020 with a Stanford-affiliated clinician from one of the following clinics: - Stanford Internal Medicine (includes University affiliated clinics) - Stanford Family Medicine (includes University affiliated clinics) - Non-EP cardiologist
Exclusion Criteria:
  1. - Advanced or poor-prognostic cancer - No active primary care at Stanford Health Care - Age <18 or >85 - Non-English or non-Spanish speaking - Baseline statin or non-statin lipid lowering therapy - Allergy to statin medication or identification of statin-associated muscle symptom


Fatima Rodriguez
Fatima Rodriguez
Associate Professor of Medicine (Cardiovascular Medicine)

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Fatima Rodriguez