학술논문

The Clinical Utility of a Precision Medicine Blood Test Incorporating Age, Sex, and Gene Expression for Evaluating Women with Stable Symptoms Suggestive of Obstructive Coronary Artery Disease: Analysis from the PRESET Registry
Document Type
article
Source
Journal of Women's Health. 28(5)
Subject
Biomedical and Clinical Sciences
Cardiovascular Medicine and Haematology
Clinical Sciences
Prevention
Atherosclerosis
Biomedical Imaging
Clinical Trials and Supportive Activities
Heart Disease
Cardiovascular
Clinical Research
Heart Disease - Coronary Heart Disease
Detection
screening and diagnosis
4.2 Evaluation of markers and technologies
Good Health and Well Being
Adult
Aged
Aged
80 and over
Clinical Decision-Making
Cohort Studies
Coronary Artery Disease
Female
Follow-Up Studies
Gene Expression Profiling
Hematologic Tests
Humans
Middle Aged
Precision Medicine
Prospective Studies
Registries
Sex Characteristics
United States
coronary artery disease
women
diagnosis
age
sex
gene expression score
registry
age/sex/gene expression score
Medical and Health Sciences
Public Health
Biomedical and clinical sciences
Health sciences
Language
Abstract
Background: Evaluating women with symptoms suggestive of coronary artery disease (CAD) remains challenging. A blood-based precision medicine test yielding an age/sex/gene expression score (ASGES) has shown clinical validity in the diagnosis of obstructive CAD. We assessed the effect of the ASGES on the management of women with suspected obstructive CAD in a community-based registry. Materials and Methods: The prospective PRESET (A Registry to Evaluate Patterns of Care Associated with the Use of Corus® CAD in Real World Clinical Care Settings) Registry (NCT01677156) enrolled 566 patients presenting with symptoms suggestive of stable obstructive CAD from 21 United States primary care practices from 2012 to 2014. Demographics, clinical characteristics, and referrals to cardiology or further functional and/or anatomical cardiac studies after ASGES testing were collected for this subgroup analysis of women from the PRESET Registry. Patients were followed for 1-year post-ASGES testing. Results: This study cohort included 288 women with a median age 57 years. The median body mass index was 29.2, with hyperlipidemia and hypertension present in 48% and 43% of patients, respectively. Median ASGES was 8.5 (range 1-40), with 218 (76%) patients having low (≤15) ASGES. Clinicians referred 9% (20/218) low ASGES versus 44% (31/70) elevated ASGES women for further cardiac evaluation (odds ratio 0.14, p