EDCAD study: precision medicine for heart disease prevention

Transforming how we identify and prevent heart disease before symptoms appear.

Between 2020 and 2024, more than 2250 Australians across two states partnered with Baker Institute researchers in one of the nation's largest studies focused on preventing heart disease. The EDCAD study combined cutting-edge genetic testing, molecular profiling and advanced imaging to detect hidden cardiovascular risk — and find better ways to motivate people to protect their heart health.

This groundbreaking research is helping shape a new era of precision medicine, where we can identify who's at risk earlier and more accurately than ever before.

What we explored

Heart disease remains Australia's leading cause of death, yet many people at risk show no symptoms until it's too late. The EDCAD study asked two critical questions:

Can we detect hidden heart disease earlier and more accurately?

Researchers tested whether combining genetic risk scores with a newly developed molecular blood test could better identify people who would benefit from further heart scans — catching disease before symptoms develop.

What motivates people to take preventative action?

The team investigated whether showing people their genetic risk or imaging results of calcium buildup in their arteries would be more effective at motivating them to take preventative medications and make lifestyle changes.

Study one
Sharper detection through precision testing

The challenge

Traditional cardiovascular risk calculators miss many people who are actually at high risk. Newer tools — like polygenic risk scores (genetic profiling) and coronary artery calcium scoring (CT imaging that detects plaque buildup) — show promise, but aren't yet part of standard screening in Australia.

What we did

All 2250+ volunteers were assessed using traditional cardiovascular risk calculations. With some progressing on to undergo:

• Polygenic risk scoring (analysing multiple genetic variants associated with heart disease).
• Blood tests to develop an integrated lipidomic risk score (molecular profiling of fats in the blood).
• Coronary artery calcium scoring via CT imaging for eligible participants.

The breakthrough

Led by Professor Peter Meikle, the research team developed mCVDRisk — Australia's first comprehensive molecular risk tool delivered through a simple blood test. By combining genetic and lipidomic (blood fat) profiles, this precision medicine approach can identify high-risk individuals more accurately than current clinical scores alone.

This represents a significant step toward personalised cardiovascular prevention — helping doctors identify who needs intervention, and sparing those at lower risk from unnecessary testing or medication.

Technical detail for researchers

The study demonstrated that molecular profiles can enhance cardiovascular disease risk prediction beyond established clinical scores. All volunteers provided blood samples to derive an integrated polygenic and lipidomic risk score.

The lipidomic component analyses complex patterns of lipid species (fats) in blood plasma that reflect underlying metabolic dysfunction associated with atherosclerosis development. When combined with polygenic risk scores, this multi-omics approach improved selection of individuals who would benefit from coronary artery calcium testing and, in turn, detection of subclinical disease.

The mCVDRisk score has been validated and this implementation project is now working to translate it from laboratory proof-of-concept into routine clinical practice across diverse Australian healthcare settings.

Key publications

Soh CH, Khanna S, Wu J, Venkataraman P, Giles C, Nerlekar N, Carrington M, Watts GF, Nicholls SJ, Meikle P, Marwick TH.
Screening for high coronary plaque volume in primary prevention: integration of multi-omics and coronary calcium scoring into cardiovascular risk assessment
AJPC Accepted Feb 2026.

Wu J, Giles C, Dakic A, Beyene H, Huynh K, Wang T, Meikle T, Olshansky G, Salim A, Duong T, Watts G, Hung J, Hui J, Cadby G, Beilby J, Blangero J, Moses E, Shaw J, Magliano D, Zhu D, Yang J, Grieve SM, Wilson A, Chow C, Vernon S, Gray M, Figtree G, Carrington M, Inouye M, Marwick T, Meikle P.
A lipidomic risk score for enhanced intermediate risk stratification of cardiovascular disease in primary prevention
J Am Coll Cardiol 2024 Jul 30;84(5):434–446

Dakic A, Wu J, Wang T, Huynh K, Mellett N, Duong T, Beyene H, Magliano D, Shaw J, Carrington M, Inouye M, Yang J, Figtree G, Curran J, Blangero J, Simes J, LIPID Study Investigators, Giles C, Meikle P.
Imputation of plasma lipid species to facilitate integration of lipidomic datasets
Nature Communications 2024;15(1)

Study two
What motivates prevention?

The challenge

Knowing you're at risk and actually doing something about it are two different things. Even when people are identified as high-risk, many don't take prescribed preventative medications or make lasting lifestyle changes — particularly when they feel perfectly healthy.

What we tested

Participants were randomly assigned to receive either:

• Their polygenic risk score (genetic risk profile), or
• Their coronary artery calcium score (imaging showing plaque buildup in arteries).

Both groups were offered statin therapy (cholesterol-lowering medication) and followed for 12 months to see which type of risk information was more effective at motivating medication adherence and behaviour change.

What we found

After 12 months, there was no significant difference in statin adherence between the two groups. However, the overall results were encouraging: 80% of participants remained on their statin therapy after 12 months, and both cholesterol levels and overall cardiovascular risk were significantly reduced across both groups.

What this means

While neither genetic nor imaging results proved more persuasive than the other, the study demonstrates that clear risk communication — regardless of the method — combined with appropriate medical support can successfully motivate people to take preventative action. The high adherence rate suggests that when people understand their risk through objective testing, many will act to protect their heart health.

Technical detail for researchers

A key focus of this component was communicating cardiovascular risk to asymptomatic individuals as a means to enhance risk perception and motivate engagement in primary prevention strategies.

Participants were randomised to receive either their polygenic risk score or coronary artery calcium score, with both groups initiated on statin therapy. The primary outcome was medication adherence at 12 months, measured through prescription refill data and self-reporting.

Preliminary findings from the CAPAR-CAD trial showed no statistically significant difference in statin adherence between genetic risk scoring and coronary artery calcium score disclosure. However, both interventions demonstrated effectiveness in reducing cardiovascular risk markers, with 80% medication persistence at 12 months and significant improvements in LDL cholesterol and calculated 10-year cardiovascular risk.

These findings suggest that objective risk disclosure through either modality, when coupled with appropriate clinical support and intervention, can effectively motivate preventative behaviour change in asymptomatic populations.

Key publication

Verma K, Marwick T, Duarte C, Meikle P, Inouye M, Carrington M.
Use of coronary computed tomography or polygenic risk scores to prompt action to reduce coronary artery risease risk: the CAPAR-CAD trial
Am Heart J 2022;248:97–107

Research team, Principal Investigators

• Professor Tom Marwick
• Professor Peter Meikle
• Professor Michael Inouye
• Associate Professor Melinda Carrington

What this means for the future

The EDCAD study represents a significant advance in our ability to prevent heart disease before it causes harm. By demonstrating that precision medicine tools — genetic testing, molecular profiling and advanced imaging — can work together to identify hidden risk, this research is paving the way for earlier, more targeted prevention.

Perhaps most importantly, it shows that when people understand their personal risk through objective testing, they're willing to take action to protect their future health. As these tools become more accessible and integrated into standard care, we move closer to a future where heart disease is caught and managed long before the first heart attack.

This research was made possible by the commitment of more than 2250 Australians who volunteered their time to advance our understanding of cardiovascular prevention. Their contribution is helping shape better heart health for generations to come.