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Blood test identifies obstructive CAD risk in symptomatic women
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A low score on a blood test that evaluates age, sex and gene expression may help to rule out the presence of obstructive CAD in symptomatic women, according to results published in Menopause.
In an aggregate analysis, Joseph A. Ladapo, MD, PhD, from the department of population health at New York University School of Medicine, and colleagues evaluated data on 320 women (mean age, 57.8 years) enrolled in the prospective IMPACT-PCP and REGISTRY I studies who presented with stable symptoms indicative of possible obstructive CAD.
Joseph A. Ladapo
All participants underwent age/sex/gene expression score (ASGES) testing (Corus CAD, CardioDx Inc.). The quantitative, in vitro test utilizes a peripheral blood sample to evaluate the patient’s current risk for obstructive CAD. An ASGES of 15 or lower is classified as low risk and a score greater than 15 is classified as elevated risk. The test was administered by primary care physicians, nurse practitioners and/or physician assistants at nine facilities in six U.S. states.
The primary outcome was the association between ASGES and referrals for additional cardiac evaluation. Median follow-up was 37 days among patients enrolled in the IMPACT-PCP study and 278 days among those in the REGISTRY I trial.
The mean ASGES score was 10.3, and ranged from 1, which designated a 1% likelihood of obstructive CAD, to 38, which designated a 62% likelihood of obstructive CAD. Three-quarters of women (77.5%) had low ASGES scores.
Four percent of women with low ASGES were referred for further evaluation compared with 83.3% of women with elevated ASGES. Most participants (78.1%) did not proceed with further testing, the researchers wrote. Major adverse cardiac events occurred in 0.9% of the population during the course of follow-up. Major adverse cardiac event or revascularization occurred in approximately 1.2%.
When evaluated as a continuous variable in 10-unit increments, ASGES was associated with referral outcome (P < .0001). The likelihood of referral was lower among women with low ASGES after adjustment for confounders, including age, tobacco use, race and BP (OR vs. elevated ASGES = 0.013; 95% CI, 0.003-0.042).
“The addition of ASGES … provides another diagnostic option early in the workup of these symptomatic women,” the researchers concluded. “ASGES, which was shown to be incorporated into medical decision-making in this analysis, may help primary care providers rule out obstructive CAD among women with low scores, and therefore identify a population of women who would not benefit from further cardiac evaluation.” – by Adam Taliercio
Disclosure: Ladapo reports receiving honoraria and research support from CardioDx Inc.
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