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Blood Test Could Help Stratify Coronary Artery Disease Patients

In a new subanalysis, results of a blood test are found to be correlated with cardiovascular event rates, potentially offering a way to classify coronary artery disease patients by risk of future events.

The Corus CAD blood test from CardioDX has new data to back its predictive powers. In a new substudy, Corus CAD, which is used to test patients for the likelihood of obstructive coronary artery disease (CAD), was found to also offer insight into a patient's risk of cardiovascular events.

Patients are given a Corus CAD score based on a 1-40 scale, with a higher score pointing to a higher chance that a patient has obstructive CAD. The latest data in nondiabetic patients shows that a higher score also correlates to a higher rate of cardiovascular events, including death, myocardial infarction, hospitalization for unstable angina, and revascularization. 

According to a press release, the 1312 patients in the substudy that had a Corus CAD score above 15 had statistically higher cardiovascular event rates than patients with scores of 1-15, with an odds ratio of 2.6 (p<0.001). This remained true after adjusting for clinical risk factors. Patients with low scores had low event rates at 25-month median follow-up that were comparable to negative, normal cardiac stress test or coronary CT-angiography test results (3.2% vs 2.6%, p=0.29).

The data, announced this weekend at the American College of Cardiology (ACC) Annual Scientific Meeting in Chicago, resulted from a 2370-patient substudy of the Prospective Multicenter Imaging Study for Evaluation of Chest Pain (PROMISE) trial, which was sponsored by the National Heart, Lung, and Blood Institute (NHLBI) and Duke University.

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The findings "highlight the characteristics of the Corus CAD test to safely and accurately help clinicians risk stratify symptomatic patients, so that patients can potentially avoid additional cardiac testing and procedures that may be potentially unncessary," said CardioDx chief medical officer Mark Monane, MD, FACP, in the press release.

In addition, the data showed that a higher rate of revascularization procedures was behind the higher cardiovascular event rate seen in high Corus CAD-scoring patients. This underscores the test's power in identifying patients with a higher likelihood of obstructive CAD, since those patients, defined as having the disease when a coronary CT-angiography test detects >70% stenosis, often need revascularization to open narrowed arteries. 

"Findings from this PROMISE substudy demonstrate the opportunity to use a simple blood test in the initial evaluation of symptomatic patients with suspected CAD to help clinicians determine next steps and make clinical decisions," said Deepak Voora, MD, assistant professor of medicine at the Duke Center for Applied Genomics and Precision Medicine, in the release. "The lower likelihood of not only CAD but risk of revascularization procedures seen in patients with low scores suggest that the score, in conjunction with a physician's clinical assessment, could provide additional information to help physicians efficiently and effectively rule out clinically significant obstructive CAD in the outpatient setting."


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