Abstract 16271: A Peripheral Blood Gene Expression Score for Obstructive Coronary Artery Disease is Significantly Associated With Major Adverse Cardiovascular Events and Revascularizations in the PREDICT Trial
Background: We previously developed and validated a gene expression score (GES) based on age, sex and 23 gene expression levels to discriminate obstructive coronary artery disease (CAD) likelihood. The relationship between this GES and major adverse cardiovascular events (MACE) and revascularizations has not been fully explored.
Methods: A total of 1328 non-diabetic patients from the PREDICT trial (NCT00500617) were monitored for 1 year post study entry and index invasive angiography for MACE (MI, stroke/TIA, all-cause mortality) and revascularizations. Gene expression scores were obtained on all patients using Corus CAD protocols (CardioDx, Palo Alto, CA). The probability of all events and procedures and only MACE >30 days post-index catheterization were examined as a function of the GES score and at pre-specified thresholds of ≤15 and ≥28.
Results: A total of 1266 patients (95%) were evaluable having both a GES and 1 year follow-up; this group had an average age 60 and was 43% female. A total of 330 patients (26%) had procedures or MACE within 30 days and 31 (2.4%) had subsequent events (10, 16, 5 for MI, stroke, and death, respectively). The GES was significantly associated with all events and procedures (p<0.001) and also retained significance when only MACE > 30 days post enrollment was analyzed (p=0.013). The odds ratio for MACE likelihood for low GES (≤15) vs high GES (≥28) was 0.32 (95% CI 0.12-0.82, p=0.018).
Conclusions: A peripheral blood gene expression score previously validated for obstructive CAD in an invasive angiography population is significantly associated with both all events and procedures and MACE > 30 days post-index catheterization with lower score patients having reduced event and procedural likelihoods.
- © 2013 by American Heart Association, Inc.