Cardiovascular Diseases
Conditions
Keywords
atherosclerotic cardiovascular disease, aspirin, high-intensity statin
Brief summary
The primary objective of the ASA-3C trial is to evaluate the role of aspirin and high-intensity statin therapy, respectively, in individuals with severe coronary calcification (coronary calcium score ≥300) to prevent atherosclerotic cardiovascular disease (ASCVD) events with severe coronary calcification (CAC ≥300).
Interventions
DRUGAspirin
Patients will take aspirin 100 mg/day.
DRUGHigh-intensity statin
Statin intensity is defined according to the 2026 ACC/AHA Guideline on the Management of Dyslipidemia
DRUGGuideline-directed statin therapy
Statin intensity is defined according to the 2026 ACC/AHA Guideline on the Management of Dyslipidemia
Sponsors
Jung-min Ahn
Study design
Allocation
RANDOMIZED
Intervention model
FACTORIAL
Primary purpose
PREVENTION
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
40 Years to 75 Years
Healthy volunteers
No
Inclusion criteria
1. The subject must be aged between 40 and 75 years. 2. Patients who have coronary artery calcium score ≥300 Agatston Unit on coronary calcium computed tomography. 3. Patients who have 1 or more CVD risk factors in below; * dyslipidemia or, * diabetes or, * hypertension or, * family history of CVD or, * smoking 4. Patients agree to the study protocol and the schedule of clinical follow-up, and provides informed, written consent, as approved by the appropriate Institutional Review Board/Ethical Committee of the respective clinical site.
Exclusion criteria
1. Individuals who have symptomatic coronary artery disease or heart failure. 2. Patients who have documented clinical Atherosclerotic Cardiovascular Disease: previous myocardial infarction, acute coronary syndrome, stable angina, coronary revascularization and other arterial revascularization procedures, stroke and Transient ischaemic attack (TIA), \>50% carotid stenosis or previous carotid endarterectomy or stenting, aortic aneurysm and peripheral artery disease. 3. Patients who have evidence of myocardial ischemia on non-invasive stress test including stress single photon emission CT myocardial perfusion imaging (SPECT MPI), cardiovascular magnetic resonance (CMR) imaging, stress echocardiography, or treadmill test, or on invasive stress test including Fractional flow reserve (FFR) \< 0.80 on invasive coronary angiography (diameter stenosis\>50% without objective evidence of ischemia could be enrolled). 4. Patients at high risk of bleeding: gastrointestinal hemorrhage or peptic ulcer within the previous 6 months; active hepatic disease such as cirrhosis or active hepatitis; use of warfarin, or other anticoagulant therapy; or has a history of aspirin allergy. 5. Patients with atrial fibrillation and flutter. 6. Patients with severe left ventricular dysfunction (ejection fraction ≤30%) or severe valvular heart disease who experience dyspnea on exertion (The NYHA (New York Heart Association) Functional Classification III-IV). 7. History of allergy or severe adverse reaction to aspirin or statin or ezetimibe. 8. History of myositis or myopathy with active disease in the 180 days prior to study entry. 9. Patients with active liver disease or persistent unexplained serum transaminase elevation. 10. Patients who have significantly abnormal findings which identified violation for safety by investigator on physical examination, blood test and electrocardiogram. 11. History of alcohol or drug abuse. 12. Concurrent medical condition with a life expectancy of less than 1 years. 13. Pregnant and/or lactating women. 14. Patient was unable to provide written informed consent or participate in log-term follow up.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Event rate of a composite of atherosclerotic cardiovascular disease event | 3 years | cardiovascular death; myocardial infarction ; hospitalization for Acute coronary syndrome; stroke; Transient ischaemic attack; peripheral arterial ischemia ;revascularization of coronary, carotid, or peripheral artery ;or death from an undetermined cause |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Event rate of Each individual component of primary composite outcome | 3 years | — |
| Event rate of Death from any causes | 3 years | — |
| Event rate of Hospitalization for heart failure | 3 years | — |
| Event rate of the first occurrence of any major bleeding | 3 years | \[Safety secondary endpoint\] major bleeding is defined as a composite of intracranial hemorrhage, site-threatening bleeding event in the eye, gastrointestinal bleeding, or any other serious bleeding that resulted in hospitalization, transfusion, or that was fatal. |
| Event rate of the Safety secondary endpoint | 3 years | Safety secondary endpoint: Aspirin the first occurrence of any major bleeding; a composite of intracranial hemorrhage, site-threatening bleeding event in the eye, gastrointestinal bleeding, or any other serious bleeding that resulted in hospitalization, transfusion, or that was fatal. Statin * Muscle related adverse events; myalgia, myositis, myopathy, myonecrosis, rhabdomyolysis * New onset diabetes mellitus * Gall bladder-related adverse events * Cancer diagnosis * Cataract operation * New-onset neurocognitive disorder * Discontinuation or dose-reduction of statin therapy by intolerance |
Countries
South Korea
Contacts
CONTACTJung-min Ahn, MD
Outcome results
None listed