Whole blood gene expression testing for coronary artery disease in nondiabetic patients: major adverse cardiovascular events and interventions in the PREDICT trial.
Whole blood gene expression testing for coronary artery disease in nondiabetic patients: major adverse cardiovascular events and interventions in the PREDICT trial.
- 2012
The majority of first-time angiography patients are without obstructive coronary artery disease (CAD). A blood gene expression score (GES) for obstructive CAD likelihood was validated in the PREDICT study, but its relation to major adverse cardiovascular events (MACE) and revascularization was not assessed. Patients (N = 1,160) were followed up for MACE and revascularization 1 year post-index angiography and GES, with 1,116 completing follow-up. The 30-day event rate was 23% and a further 2.2% at 12 months. The GES was associated with MACE/revascularizations (p < 0.001) and added to clinical risk scores. Patients with GES >15 trended towards increased >30 days MACE/revascularization likelihood (odds ratio = 2.59, 95% confidence interval = 0.89-9.14, p = 0.082). MACE incidence overall was 1.5% (17 of 1,116) and 3 of 17 patients had GES <= 15. For the total low GES group (N = 396), negative predictive value was 90% for MACE/revascularization and >99% for MACE alone, identifying a group of patients without obstructive CAD and highly unlikely to suffer MACE within 12 months.
English
*Coronary Artery Disease/di [Diagnosis]
*Genetic Testing
Adult
Aged
Aged, 80 and over
Angioplasty, Balloon, Coronary
Coronary Angiography
Coronary Artery Bypass
Coronary Artery Disease/co [Complications]
Coronary Artery Disease/ge [Genetics]
Coronary Artery Disease/mo [Mortality]
Coronary Artery Disease/ra [Radiography]
Coronary Artery Disease/th [Therapy]
Female
Gene Expression Regulation
Genetic Predisposition to Disease
Humans
Ischemic Attack, Transient/et [Etiology]
Logistic Models
Male
Middle Aged
Myocardial Infarction/et [Etiology]
Odds Ratio
Phenotype
Predictive Value of Tests
Prognosis
Prospective Studies
Reproducibility of Results
Risk Assessment
Risk Factors
Stroke/et [Etiology]
Time Factors
United States
MedStar Heart & Vascular Institute
Journal Article
Multicenter Study
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
The majority of first-time angiography patients are without obstructive coronary artery disease (CAD). A blood gene expression score (GES) for obstructive CAD likelihood was validated in the PREDICT study, but its relation to major adverse cardiovascular events (MACE) and revascularization was not assessed. Patients (N = 1,160) were followed up for MACE and revascularization 1 year post-index angiography and GES, with 1,116 completing follow-up. The 30-day event rate was 23% and a further 2.2% at 12 months. The GES was associated with MACE/revascularizations (p < 0.001) and added to clinical risk scores. Patients with GES >15 trended towards increased >30 days MACE/revascularization likelihood (odds ratio = 2.59, 95% confidence interval = 0.89-9.14, p = 0.082). MACE incidence overall was 1.5% (17 of 1,116) and 3 of 17 patients had GES <= 15. For the total low GES group (N = 396), negative predictive value was 90% for MACE/revascularization and >99% for MACE alone, identifying a group of patients without obstructive CAD and highly unlikely to suffer MACE within 12 months.
English
*Coronary Artery Disease/di [Diagnosis]
*Genetic Testing
Adult
Aged
Aged, 80 and over
Angioplasty, Balloon, Coronary
Coronary Angiography
Coronary Artery Bypass
Coronary Artery Disease/co [Complications]
Coronary Artery Disease/ge [Genetics]
Coronary Artery Disease/mo [Mortality]
Coronary Artery Disease/ra [Radiography]
Coronary Artery Disease/th [Therapy]
Female
Gene Expression Regulation
Genetic Predisposition to Disease
Humans
Ischemic Attack, Transient/et [Etiology]
Logistic Models
Male
Middle Aged
Myocardial Infarction/et [Etiology]
Odds Ratio
Phenotype
Predictive Value of Tests
Prognosis
Prospective Studies
Reproducibility of Results
Risk Assessment
Risk Factors
Stroke/et [Etiology]
Time Factors
United States
MedStar Heart & Vascular Institute
Journal Article
Multicenter Study
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't