Precision, Noninvasive Test Could Help Detect CAD in Older Adults

A blood-based precision medicine test that incorporates age, sex, and gene expression score (ASGES) could help to diagnose elderly individuals with coronary artery disease (CAD), according to the results of a recent study.

The diagnosis of CAD can be challenging in older adults, with current approaches requiring the exposure of individuals to risks from contrast dyes and invasive procedures.
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For their study, researchers aimed to test the validity of the ASGES test, a blood-based precision medicine test, for the identification of CAD in older individuals.

The test involved 176 stable, nonacute outpatients presenting with symptoms suggesting obstructive CAD aged 65 years and older.

The researchers collected information on demographic characteristics, clinical factors, ASGES results (range 1-40 [low ≤15, high >15]), and major adverse cardiac events (MACEs) during the study. Follow-up was 1 year after ASGES testing.

Overall, the median ASGES score was 25, with 40 (23%) participants having a low score. Clinicians referred 12.5% of participants with low ASGES scores and 49.3% of those with high ASGES scores to cardiology or advanced cardiac testing, with higher scores being associated with greater likelihood of posttest cardiac referral. At 1 year, the incidence of MACE was 10% in those with high ASGES scores and 0% in those with low ASGES scores.

“The ASGES test showed potential clinical utility in the evaluation of elderly outpatients with symptoms suggestive of obstructive CAD. Test use may reduce unnecessary referrals and the risk of procedure-related complications in individuals with low ASGES, who are unlikely to benefit from further testing, while also identifying individuals who may benefit from further cardiac evaluation and management,” the researchers concluded.

—Michael Potts

Reference:

Ladapo JA, Budoff MJ, Sharp D, et al. Utility of a precision medicine test in elderly adults with symptoms suggestive of coronary artery disease [published online December 6, 2017]. JAGS. DOI: 10.1111/jgs.15215.