# Early and Personalized Cardiovascular Disease Preventive Care in Lupus Nephritis (EPiC-LN)

> **NIH NIH K23** · UNIVERSITY OF WISCONSIN-MADISON · 2024 · $173,472

## Abstract

PROJECT SUMMARY/ABSTRACT
Atherosclerotic cardiovascular disease (ASCVD) is the leading cause of mortality in patients with lupus nephritis
(LN). Moreover, LN patients of Black race face even higher ASCVD risk. Less than 15% of eligible LN patients
receive ASCVD prevention. This is because clinicians and patients need to know: a) who is at risk and will benefit
most from ASCVD prevention; b) how to start and tailor therapies per each patient’s risk; and c) what is the
efficacy and safety of ASCVD therapies during pregnancy—fears of young women that lead to stopping such
therapies. This proposal is designed to provide Dr. Shivani Garg, MD, MS with the training needed to become
an independent physician scientist researching interventions to improve ASCVD prevention in LN.
The goal of the proposed research is to develop effective ASCVD preventive interventions that support clinicians
and patients in decision-making and support use of ASCVD-risk reducing therapies to improve outcomes and
survival in LN. Garg’s earlier innovative work identified that subclinical renal arteriosclerosis in kidneys at LN
diagnosis is a window into the heart. This approach can identify patients who will benefit from ASCVD prevention
at LN diagnosis. To answer the two remaining questions/concerns of patients and clinicians, Garg’s project will:
a) Develop an implementation guide for clinicians to support decisions to 1) tailor ASCVD prevention by each
 patient’s risk; and 2) start ASCVD-risk reducing therapies based on evidence for effectiveness and safety
 (Aim 1). Using a validated method that combines scientific evidence from literature and expert consensus this
 guide will be developed. A retrospective performance testing will be done to test its public health impact.
b) Create a shared decision-making tool to support patients and clinicians in decision-making and identifying the
 best aligned approach to their personalized ASCVD preventive care (Aim 2). This tool will be informed by
 feedback from multidisciplinary experts, clinicians, and patients of diverse backgrounds to ensure biases and
 difficult concepts are addressed thereby delivering a racially, culturally, and socially appropriate tool.
c) Test the guide and shared decision-making tool in clinics to evaluate if patients and clinicians will adopt, use,
 and recommend the tools (Aim 3). Additionally, this step will inform the real-world impact and feasibility of
 using such interventions in busy clinics.
The data from this project, along with the novel correlations with subclinical renal arteriosclerosis, offer a
foundation for a multi-site R01 study to test the effectiveness of ASCVD preventive interventions in reducing the
risk of ASCVD in LN. Dr. Garg is in an ideal environment to complete this research and receive mentored training
in implementation and decision science, qualitative methods, health equity, and clinical trials. This proposal
addresses a significant clinical dilemma and serious gaps in ASCVD...

## Key facts

- **NIH application ID:** 10949235
- **Project number:** 1K23AR084608-01
- **Recipient organization:** UNIVERSITY OF WISCONSIN-MADISON
- **Principal Investigator:** SHIVANI GARG
- **Activity code:** K23 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $173,472
- **Award type:** 1
- **Project period:** 2024-08-20 → 2029-07-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10949235

## Citation

> US National Institutes of Health, RePORTER application 10949235, Early and Personalized Cardiovascular Disease Preventive Care in Lupus Nephritis (EPiC-LN) (1K23AR084608-01). Retrieved via AI Analytics 2026-05-25 from https://api.ai-analytics.org/grant/nih/10949235. Licensed CC0.

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