Cardiology 2013. Part II.

Notes: McFadden, S L

Hughes, C M

Winder, R J

eng

Multicenter Study

England

2013/03/14 06:00

J Radiol Prot. 2013 Jun;33(2):313-9. doi: 10.1088/0952-4746/33/2/313. Epub 2013 Mar 13.

URL: http://www.ncbi.nlm.nih.gov/pubmed/23482399

Author Address: Centre for Health and Rehabilitation Technologies, Institute of Nursing and Health Research, School of Health Sciences, University of Ulster at Jordanstown, Shore Road, Newtownabbey, County Antrim, UK.

 

 

Reference Type:  Journal Article

Record Number: 874Author: McPherson, J. A., Davis, K., Yau, M., Beineke, P., Rosenberg, S., Monane, M. and Fredi, J. L.

Year: 2013

Title: The clinical utility of gene expression testing on the diagnostic evaluation of patients presenting to the cardiologist with symptoms of suspected obstructive coronary artery disease: results from the IMPACT (Investigation of a Molecular Personalized Coronary Gene Expression Test on Cardiology Practice Pattern) trial

Journal: Crit Pathw Cardiol

Volume: 12

Issue: 2

Pages: 37-42

Date: Jun

Short Title: The clinical utility of gene expression testing on the diagnostic evaluation of patients presenting to the cardiologist with symptoms of suspected obstructive coronary artery disease: results from the IMPACT (Investigation of a Molecular Personalized Coronary Gene Expression Test on Cardiology Practice Pattern) trial

Alternate Journal: Critical pathways in cardiology

ISSN: 1535-2811 (Electronic)

1535-2811 (Linking)

DOI: 10.1097/HPC.0b013e3182822bd0

Accession Number: 23680805

Keywords: Adult

Aged

Case-Control Studies

Cohort Studies

Coronary Angiography

Coronary Artery Disease/*diagnosis/*genetics

Female

Gene Expression/*genetics

Gene Expression Profiling/*methods

Genetic Testing/*utilization

Humans

Male

Middle Aged

Prospective Studies

Abstract: Accurate, noninvasive evaluation for obstructive coronary artery disease (CAD) remains challenging and inefficient. In this study, 171 patients presenting with stable chest pain and related symptoms without a history of CAD were referred to 6 cardiologists for evaluation. In the prospective cohort of 88 patients, the cardiologist’s diagnostic strategy was evaluated before and after gene expression score (GES) testing. The GES is a validated, quantitative blood-based diagnostic test measuring peripheral blood cell expression levels of 23 genes to determine the likelihood of obstructive CAD (at least 1 vessel with >/= 50% angiographic coronary artery stenosis). The objective of the study was to measure the effect of the GES on diagnostic testing using a pre/post study design. There were 83 prospective patients evaluable for study analysis, which included 57 (69%) women, mean age 53 +/- 11 years, and mean GES 12.5 +/- 9. Presenting symptoms were classified as typical angina, atypical angina, and noncardiac chest pain in 33%, 60%, and 7% of patients (n = 27, 50, and 6), respectively. After GES, changes in diagnostic testing occurred in 58% of patients (n = 48, P < 0.001). Of note, 91% (29/32) of patients with decreased testing had low GES (</= 15), whereas 100% (16/16) of patients with increased testing had elevated GES (P < 0.001). A historical cohort of 83 patients, matched to the prospective cohort by clinical factors, had higher diagnostic test use compared with the post-GES prospective cohort (P < 0.001). In summary, the GES showed clinical utility in the evaluation of patients with suspected obstructive CAD presenting to the cardiologist’s office.

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