{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T16:31:16Z","timestamp":1791563476795,"version":"4.3.4"},"reference-count":37,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T00:00:00Z","timestamp":1780272000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T00:00:00Z","timestamp":1780272000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Cardiology"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The contemporary management of type 2 diabetes (T2D) involves a multifaceted model of care integrating intensive management of lipids, blood pressure, and glucose, along with lifestyle modifications. Despite these efforts, cardiovascular disease (CVD) remains a leading cause of morbidity and mortality among patients with T2D, largely due to suboptimal adherence to preventive strategies. The VOLTAIRE trial aims to assess the impact of providing personalized cardiovascular risk information derived from computed tomography coronary angiography (CTCA) and a polygenic risk score (PRS) on cardiovascular risk factor modification.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>VOLTAIRE evaluates whether integrating CTCA and PRS into risk counseling enhances adherence to lifestyle and pharmacological interventions, ultimately improving cardiovascular outcomes among patients with T2D.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>VOLTAIRE is a prospective three\u2010arm, parallel\u2010group, randomized controlled trial enrolling participants aged 40 years or older with T2D and no established atherosclerotic CVD. Participants are randomized 1:1:1 to receive: (1) risk factor counseling plus CTCA result, (2) risk factor counseling plus PRS result, or (3) standard risk factor counseling (control). Nurse\u2010led motivational interviewing is used for risk counseling. The primary outcome is change in non\u2010calcified plaque volume measured by serial CTCA at 12 months. Secondary outcomes include low\u2010density lipoprotein cholesterol levels, adherence to medication, patient engagement, CVD knowledge improvements, and psychological outcomes over 12 months. Enrollment began in August 2023.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>VOLTAIRE seeks to determine if coupling nurse\u2010led risk factor counseling with personalized CTCA or PRS information improves cardiovascular outcomes, adherence, and participant engagement in T2D management.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/clc.70363","type":"journal-article","created":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T13:19:44Z","timestamp":1780319984000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Evaluation of Polygenic Scores and CT Imaging in Risk Factor Modification in Patients With Diabetes: Rationale and Design of the VOLTAIRE Study"],"prefix":"10.1002","volume":"49","author":[{"given":"Ruofei","family":"Chen","sequence":"first","affiliation":[{"name":"Monash Victorian Heart Institute Monash University Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adam J.","family":"Nelson","sequence":"additional","affiliation":[{"name":"Monash Victorian Heart Institute Monash University Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sophia","family":"Zoungas","sequence":"additional","affiliation":[{"name":"School of Public Health and Preventive Medicine Monash University Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robyn A.","family":"Clark","sequence":"additional","affiliation":[{"name":"Caring Future Institute, College of Nursing and Health Sciences Flinders University Adelaide South Australia Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sean","family":"Tan","sequence":"additional","affiliation":[{"name":"Monash Victorian Heart Institute Monash University Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Esther F.","family":"Davis","sequence":"additional","affiliation":[{"name":"Monash Victorian Heart Institute Monash University Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melissa C.","family":"Southey","sequence":"additional","affiliation":[{"name":"Monash Victorian Heart Institute Monash University Melbourne Victoria Australia"},{"name":"Department of Clinical Pathology The University of Melbourne Melbourne Victoria Australia"},{"name":"Cancer Epidemiology Division Cancer Council Victoria Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Domenic","family":"Sacca","sequence":"additional","affiliation":[{"name":"Monash Victorian Heart Institute Monash University Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew","family":"Lin","sequence":"additional","affiliation":[{"name":"Monash Victorian Heart Institute Monash University Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giuseppe Di","family":"Giovanni","sequence":"additional","affiliation":[{"name":"Monash Victorian Heart Institute Monash University Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2706-4317","authenticated-orcid":false,"given":"Masashi","family":"Fujino","sequence":"additional","affiliation":[{"name":"Monash Victorian Heart Institute Monash University Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tayla","family":"Micheli","sequence":"additional","affiliation":[{"name":"Monash Victorian Heart Institute Monash University Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen J.","family":"Nicholls","sequence":"additional","affiliation":[{"name":"Monash Victorian Heart Institute Monash University Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,6,1]]},"reference":[{"key":"e_1_2_10_2_1","unstructured":"Heart Foundation. 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