PRE-EMPT: Prospective RandomizEd Evaluation and Management of Premature aTherosclerosis

Recruiting now · Phase 3 · Has a placebo group

Conditions studied: Coronary Artery Disease Risk Factors Multiple, Coronary Artery Disease Progression, Prevention & Control, Premature Atherosclerosis

In brief

Heart disease is the leading cause of death for men, women, and people of most racial and ethnic groups in the United States. This clinical trial will test if screening and early treatment of mild heart disease works. PRE-EMPT will screen individuals at low 10-year risk of heart disease with heart disease risk factors to identify those who already have early cholesterol build up, also called "plaque", in their heart arteries. It consists of two phases: 1. A Screening Study - Participants will be assessed for plaque by one or both of these scans. * Coronary Artery Calcium (CAC) Scan: A CT scan that looks for calcium or plaque in heart arteries. * Coronary CT Angiography (CCTA) Scan: A CT scan that uses contrast dye to create detailed 3D pictures of heart arteries to look for plaque. 2. A Treatment Trial (approximately 1,500 participants) - Based on the results of the CCTA, participants may be randomized into a two-year trial to test medications aimed at reducing or stabilizing plaque. Participants will have a 1 in 4 chance of receiving only placebo, and a 3 in 4 chance of receiving at least one active medication. Participants will take two pills once a day-either both active medications, one active and one placebo, or both placebos. * Rosuvastatin 20 mg: a cholesterol-lowering medicine * Colchicine 0.5 mg: a medication that lowers inflammation Everyone in the trial will be given information and advice on heart-healthy diet and lifestyle. Participants will have up to two in-person visits for the screening study, then phone visits for the Treatment Trial at the beginning, 3 months, 12 months and 24 months when they will also have an in-person visit for a CCTA Scan. Participants will have blood drawn using an at-home collection device mailed to their home at the beginning, 3 months, and end of the study.

Key facts

Study ID: NCT07232069
Run by: Duke University
People needed: 1500
Starts: 2026-07-21
Expected to finish: 2031-07-01
Last updated by the study team: 2026-08-03

Who can join

Age: 30 and older, up to 60. Sex: any. Healthy volunteers: not accepted.

You may qualify if…

Women aged 40-60 years; Men aged 30-50 years
Willing and able to provide informed consent and comply with study procedures
Smart phone user
Use of highly effective contraception by females with reproductive potential.
CAC score 1-99 in the screening study or entry through the known plaque pathway (with mild CAC or CAC<100 if known; elevated CAC on baseline CCTA is not exclusionary in the known plaque arm)
Diagnostic baseline CCTA with NCPV ≥10 mm3 as assessed by the central core lab

You may not qualify if…

Clinical diagnosis of ASCVD including coronary artery disease (CAD), peripheral arterial disease (PAD) or cerebrovascular disease (CeVD)
Current symptoms thought to be from CAD
PREVENT ASCVD 10-year risk ≥5% (if known)
Diabetes Mellitus (DM) as defined by any of the following: DM diagnosis in the medical record or HbA1C of 6.5% or greater. (if known)
LDL-C ≥190mg/dL (most recent, if known)
HIV (if known)
Severe liver disease or untreated Hepatitis C infection (if known)
Pregnancy, lactation or intending to become pregnant during the study period of 2 years
eGFR <45mL/min/1.73m2 (if known)
AST or ALT >1.5x the upper limit of normal (if known)
BMI>40kg/m2 or unable to have a CCTA scan for any reason
Allergy to iodinated intravenous contrast or other contraindication to CCTA
Current or previous use of lipid lowering therapy or colchicine
Known allergic reactions or sensitivity to the study intervention(s), including known intolerance or contraindication(s) to statin or colchicine, or long-term use of medications that are contraindicated with colchicine or rosuvastatin.
Systemic cancer undergoing active treatment
PREVENT ASCVD 10-year risk ≥5%
eGFR <45 ml/min/1.73m2 per baseline labs, (2021 CKD-EPI equation will be used if multiple options are available)
Hemoglobin A1c ≥6.5% per baseline labs
LDL-C ≥190mg/dL per baseline labs
Severe proximal coronary artery stenosis as determined by the central core lab (≥50% left main or ≥70% proximal major coronary artery stenosis)
Known contraindication to follow-up CCTA (e.g., new IV contrast allergy discovered during the baseline CCTA)
Individuals who are excluded based on any of these factors will be notified as to the reason for exclusion and encouraged to follow-up locally to address this medical issue with their treating physician.

Where it is running

University of Alabama at Birmingham — Birmingham, Alabama, United States (enrolling)
Lundquist Institute for Biomedical Innovation at Harbor UCLA Medical Center — Los Angeles, California, United States (enrolling)
Weill Cornell Medicine — New York, New York, United States (enrolling)
Duke University Hospital — Durham, North Carolina, United States (enrolling)
Wellstar Kennestone Hospital — Hiram, Georgia, United States
University of Chicago — Chicago, Illinois, United States
Johns Hopkins University — Baltimore, Maryland, United States
Massachusetts General Hospital Brigham — Boston, Massachusetts, United States
Essentia Health — Duluth, Minnesota, United States
Northern Westchester Hospital — Mount Kisco, New York, United States
New York University Langone — New York, New York, United States
Inova Health System — Fairfax, Virginia, United States
Marshfield Clinical Research Institute — Marshfield, Wisconsin, United States
Wake Forest University, Advocate Health — Winston-Salem, North Carolina, United States
Oregon Health and Sciences University — Portland, Oregon, United States
Thomas Jefferson University — Philadelphia, Pennsylvania, United States
University of Pittsburgh Medical Center — Pittsburgh, Pennsylvania, United States
Medical University of South Carolina (MUSC) — Charleston, South Carolina, United States
Vanderbilt University — Nashville, Tennessee, United States
Houston Methodist Hospital — Houston, Texas, United States
Cardiology Associates — Mobile, Alabama, United States
University of California, Los Angeles — Los Angeles, California, United States
University of Virginia (UVA) — Charlottesville, Virginia, United States

Full record on ClinicalTrials.gov

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