Whole blood gene expression testing for coronary artery disease in nondiabetic patients: major adverse cardiovascular events and interventions in the PREDICT trial.
Citation: Journal of Cardiovascular Translational Research . 5(3):366-74, 2012 Jun.PMID: 22396313Institution: MedStar Heart & Vascular InstituteForm of publication: Journal ArticleMedline article type(s): Journal Article | Multicenter Study | Research Support, N.I.H., Extramural | Research Support, Non-U.S. Gov'tSubject headings: *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 StatesYear: 2012Abstract: 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.Fiscal year: FY2012Digital Object Identifier: Date added to catalog: 2013-09-17| Item type | Current library | Collection | Call number | Status | Date due | Barcode |
|---|---|---|---|---|---|---|
| Journal Article | MedStar Authors Catalog | Article | 22396313 | Available | 22396313 |
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.
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