We can “scarcely imagine a more exciting time to be engaged in translational research” in cardiology. This is the opinion of the authors of a recent American Heart Association (AHA) 2017 Scientific Statement, The Expressed Genome in Cardiovascular Diseases and Stroke: Refinement, Diagnosis, and Prediction. The statement, which was published in Circulation: Cardiovascular Genetics, discussed the recent and expected “enormous progress in the application of the approaches to the study of specific cardiovascular diseases.”
One test cited in the paper as being clinically useful and valid is the commercially available Corus CAD test for obstructive coronary artery disease (CAD). This test was found to have the largest body of clinical evidence for CAD gene expression profiling, and I have found it to be a valuable tool for helping to manage my patients’ cardiovascular health. Corus CAD is a simple blood test that uses age, sex, and gene expression to calculate a score that helps clinicians determine whether a patient currently has obstructive CAD. Low test scores (≤ 15 on a scale of 1 to 40) indicate a low likelihood that the patient currently has a hemodynamically significant coronary artery stenosis. In these cases, we can then look for other causes of the patients’ symptoms while avoiding the catheterization lab, IV dye, radiation, and other potential adverse effects that come with standard testing. Eliminating unnecessary procedures based on Corus CAD results can also help reduce healthcare costs and exposure to unnecessary risks without compromising patient safety or outcomes.
Corus CAD gives clinicians insight into a patient’s current state of heart health in a less invasive, risky, and costly manner compared with the current standard of care. The test provides real-time information that allows us to say to our patients, “You don’t have a significant blockage in your heart arteries; we need to look elsewhere for the cause of your symptoms.” As a result, Corus CAD enables clinicians to quickly and accurately direct appropriate care pathways that are individualized to the immediate needs of each patient.
Of course, the promise of any new healthcare technology can only be realized when it is fully implemented in clinical settings. A key challenge to broad adoption of new tests, such as Corus CAD, is the time needed for professional organizations and government agencies to update their clinical guidelines and acknowledge the tests’ value. The recent AHA Statement is an important validation of new testing technologies, giving clinicians the comfort they need to implement Corus CAD and other cited tests in their practices. In addition to clinician support, broad adoption of advanced testing methods also requires that payers review and update their coverage policies for such tests. Only through the coordinated efforts of all stakeholders in the cardiology community can we truly advance cardiovascular medicine and ensure that our patients have access to cutting edge technologies that can help all of us provide the best care possible.
Readings & Resources (click to view)
Musunuru K, Ingelsson E, Fornage M, et al. The expressed genome in cardiovascular diseases and stroke: refinement, diagnosis, and prediction: a scientific statement from the American Heart Association. Circulation: Cardiovascular Genetics. 2017;10:e000037. Available at http://circgenetics.ahajournals.org/content/10/4/e000037.