A Blood-Based Gene Expression Test for Obstructive Coronary Artery Disease Tested in Symptomatic Nondiabetic Patients Referred for Myocardial Perfusion Imaging The COMPASS Study
| Autor: | Hsiao D. Lieu, Gregory S. Thomas, Charles E. Phelps, John A. McPherson, Alexandra J. Lansky, Pamela S. Douglas, Joseph A. Ladapo, Susan E. Daniels, Michael Elashoff, Szilard Voros, Mary E. Winn, Andrea Johnson, Timothy M. Bateman, Steven A. Rosenberg |
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| Rok vydání: | 2013 |
| Předmět: |
Adult
Male medicine.medical_specialty Neutrophils Population Gene Expression Constriction Pathologic Coronary Artery Disease Coronary Angiography Coronary artery disease Myocardial perfusion imaging Sex Factors Double-Blind Method Internal medicine Prevalence Genetics medicine Clinical endpoint Humans Prospective Studies education Genetics (clinical) Computed tomography angiography education.field_of_study medicine.diagnostic_test business.industry Age Factors Myocardial Perfusion Imaging Middle Aged medicine.disease Confidence interval Clinical trial Stenosis ROC Curve Area Under Curve Cardiology Female Radiology Tomography X-Ray Computed Cardiology and Cardiovascular Medicine business Algorithms |
| Zdroj: | Circulation: Cardiovascular Genetics. 6:154-162 |
| ISSN: | 1942-3268 1942-325X |
| DOI: | 10.1161/circgenetics.112.964015 |
| Popis: | Background— Obstructive coronary artery disease diagnosis in symptomatic patients often involves noninvasive testing before invasive coronary angiography. A blood-based gene expression score (GES) was previously validated in nondiabetic patients referred for invasive coronary angiography but not in symptomatic patients referred for myocardial perfusion imaging (MPI). Methods and Results— This prospective, multicenter study obtained peripheral blood samples for GES before MPI in 537 consecutive patients. Patients with abnormal MPI usually underwent invasive coronary angiography; all others had research coronary computed tomographic angiography, with core laboratories defining coronary anatomy. A total of 431 patients completed GES, coronary imaging (invasive coronary angiography or computed tomographic angiography), and MPI. Mean age was 56±10 years (48% women). The prespecified primary end point was GES receiver-operating characteristics analysis to discriminate ≥50% stenosis (15% prevalence by core laboratory analysis). Area under the receiver-operating characteristics curve for GES was 0.79 (95% confidence interval, 0.73–0.84; P 15. Site and core-laboratory MPI had areas under the curve of 0.59 and 0.63, respectively, significantly less than GES. Conclusions— GES has high sensitivity and negative predictive value for obstructive coronary artery disease. In this population clinically referred for MPI, the GES outperformed clinical factors and MPI. Clinical Trial Registration— URL: http://www.clinicaltrials.gov . Unique identifier: NCT01117506. |
| Databáze: | OpenAIRE |
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