February 5, 2010

Genetic test for coronary artery disease available

Genetic test for coronary artery disease available

Vanderbilt Heart & Vascular Institute is among the first institutions in the country, and the only one in Tennessee, to offer a gene expression test that identifies patients at high risk for obstructive coronary artery disease (CAD).

“We now have a novel way to check for the presence of significant CAD by looking at genomics, the expression of significant genes that are associated with heart disease,” said John McPherson, M.D., director of the Cardiovascular Intensive Care Unit at Vanderbilt University Medical Center.

John McPherson, M.D.

John McPherson, M.D.

“This is the first of many future tests that will move in the direction of evaluating diseases by looking at a patient's genetics and the dynamic changes in expression of genes when disease is present.”

McPherson participated in the Personalized Risk Evaluation and Diagnosis in the Coronary Tree (PREDICT) study to evaluate the non-invasive Corus CAD (CardioDX) blood test. He and researchers from 40 centers across the country collected more than 2,800 samples from 1,795 patients without diabetes and with chest pain or at risk for CAD, who were undergoing invasive coronary angiography.

PREDICT was a validation study to determine if the Corus CAD test accurately predicted a significant coronary artery blockage by looking at the gene expression levels from 23 different genes.

“We determined that the Corus CAD test is an accurate way to determine this. It is a simple blood test that offers a good predictive value of CAD in patients with chest pain,” McPherson said. “This is another tool in our tool box. For now, we will use it in addition to, and sometimes instead of, our standard approach to evaluating patients for CAD in the physician office.”

Currently, the presence of obstructive CAD in patients with stable chest pain is most often evaluated through functional and/or anatomical assessment of the heart and its vessels, including stress echocardiography, myocardial perfusion imaging and computed tomography CT angiography.

However, despite advances in imaging technology, these techniques can be subjective and challenging for cardiologists, because of variation in presenting symptoms and each patient's unique disease characteristics.

Corus CAD provides unique genomic information about an individual's disease processes at the molecular and cellular levels. When this information is combined with standard clinical assessments, physicians obtain a more complete picture of their patient's disease and can better individualize patient care.

Corus CAD is now commercially available, but Vanderbilt is the only medical center in Tennessee that has access to it. It is offered as a test in the physician office setting and is not recommended for patients with acute chest pain who present to the Emergency Department.