Abstract 16150: A Novel Blood-based Assay for Accurate Diagnosis of Coronary Artery Disease and Acute Coronary Syndromes Based on a Leukocyte Capture CD Antibody Microarray
Introduction: No blood test is currently available to diagnose the presence of coronary artery disease (CAD), or non-MI acute coronary syndromes (ACS). We developed an antibody microarray blood test to positively identify patients with CAD and ACS with high reliability, based on 100–150 different antibodies directed against cell-surface leukocyte CD antigens. Antibody dots separated by 1 mm are robotically arrayed in duplicate pattern on a nitrocellulose-coated glass slide.
Methods: We isolated peripheral blood mononuclear cells (PBMCs) from 5–10ml of venous blood and applied 4 × 106 cells to the moistened array. Anti-CD antibody dots (450 μ diameter) capture PBMCs displaying corresponding antigens, where the number of immobilized PBMCs is proportional to the number in the applied sample. Differential patterns of dot intensities arise from the light scattered from each dot and represent captured T cells, B cells, monocytes and other mononuclear cells. These patterns (see Figure) were used to differentiate healthy blood donors (n=40), patients with stable angina (SA, n=23), ACS (n= 57,) including unstable angina (UA, n=19), NSTEMI (n=21) and STEMI (n=17). Data were analysed by Support Vector Machine- based classifications on 100 rounds of 3-fold cross-validation..
Results: Patients with CAD were reliably differentiated from healthy donors, and patients with ACS differentiated from non-ACS subjects. Values are mean ± SD of the area under the receiver operator curves (AUROC) for comparisons. Classification AUROC (± SD) Healthy vs. SA 0.88 ± 0.06 Healthy vs. UA 0.91 ± 0.06 Healthy vs. MI 0.91 ± 0.05 Healthy vs. ACS 0.92 ± 0.05 Healthy vs. CAD 0.91 ± 0.05 SA vs. UA 0.75 ± 0.11 Healthy or SA vs. UA 0.80 ± 0.06
Conclusions: This novel leukocyte assay can diagnose CAD, and ACS even in the absence of MI, and is likely to fill an unmet clinical need in hospital and outpatient practice.
- © 2010 by American Heart Association, Inc.