Heart imaging versus traditional risk assessment for preventing heart disease

This trial is testing whether using advanced heart imaging to directly visualize coronary artery disease — rather than relying solely on risk factors like age and cholesterol — helps prevent heart attacks and other cardiovascular events in people with type 2 diabetes, prediabetes, or metabolic syndrome. Half of participants will receive usual care guided by traditional risk factors, while the other half will receive personalized care based on their imaging results and managed by a remote cardiology team.

Despite widespread treatment of traditional risk factors like high cholesterol and high blood pressure, heart disease remains the leading cause of death. The current approach treats many people with risk factors who never develop heart disease, while missing others who have significant heart disease despite few risk factors. This trial tests whether direct imaging can better identify who truly needs treatment and what treatments work best for each person.