{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T00:15:22Z","timestamp":1793319322717,"version":"4.5.0"},"reference-count":40,"publisher":"Oxford University Press (OUP)","license":[{"start":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T00:00:00Z","timestamp":1787875200000},"content-version":"am","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"name":"Noncommunicable Chronic Diseases-National Science and Technology Major Project","award":["2024ZD0521700"],"award-info":[{"award-number":["2024ZD0521700"]}]},{"name":"National Natural Science Foundation of China Major Project on Intelligent Diagnosis and Treatment","award":["82441019"],"award-info":[{"award-number":["82441019"]}]},{"name":"Jinling Hospital"},{"DOI":"10.13039\/501100008048","name":"Nanjing University","doi-asserted-by":"publisher","award":["22LCYY-LH2"],"award-info":[{"award-number":["22LCYY-LH2"]}],"id":[{"id":"10.13039\/501100008048","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>Cardiovascular disease (CVD) risk assessment and risk-guided lipid management are cornerstones of primary prevention of atherosclerotic coronary artery disease (ACAD). However, the 10-year CVD risk is often limited by individual-level inaccuracy and poor adherence. This trial aimed to determine whether a coronary computed tomography angiography (CCTA)-guided strategy improves lipid management in asymptomatic populations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>This pragmatic, open-label, assessor-blinded randomized trial was conducted in Nanjing, China. Asymptomatic community-dwelling adults aged 40\u201369 years with no history of CVD or prior use of lipid-lowering medication (LLM) were recruited. Participants were randomized to receive individualized LLM recommendations based either on CCTA findings (CCTA group) or on 10-year CVD risk (usual-care group). The primary outcome was the proportion of participants with regular LLM use (\u226524 of preceding 30 days) at both the 6-month and 12-month follow-up visits. Of 3503 randomized participants, 3491 (1748 CCTA, 1743 usual-care) were included in the primary analysis (median [IQR] age, 55 [48\u201361] years; 60.2% women). Among 1516 participants undergoing CCTA, ACAD was detected in 565 (37.3%). The median follow-up was 12.5 months. Regular LLM use was higher in the CCTA group than in the usual-care group (12.5% [218\/1748] vs. 8.1% [141\/1743]; adjusted risk ratio, 1.57 [95% confidence interval, 1.29\u20131.91]; P &amp;lt; 0.001). During follow-up, invasive coronary procedures were more frequent in the CCTA group than in the usual-care group (29 procedures vs. 1).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In asymptomatic populations, a CCTA-guided strategy modestly improved lipid management, though it increased invasive coronary procedures. Longer follow-up is needed to determine its effect on clinical events.<\/jats:p>\n                    <jats:p>Study Registration \u00a0http:\/\/www.clinicaltrials.com; Identifier: NCT05725096.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/eurjpc\/zwag418","type":"journal-article","created":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T11:33:53Z","timestamp":1787052833000},"source":"Crossref","is-referenced-by-count":1,"title":["Coronary computed tomography angiography to guide lipid management in an asymptomatic community-based population: RESPECT2 randomized controlled trial"],"prefix":"10.1093","author":[{"given":"Xiang","family":"Guo","sequence":"first","affiliation":[{"name":"Department of Radiology, Jinling Hospital, Affiliated Hospital of Medical School, Nanjing University , 305 Zhongshan East Road Nanjing, Jiangsu 210002 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