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Research ArticleOriginal Research

Utility of a Genomic-based, Personalized Medicine Test in Patients Presenting With Symptoms Suggesting Coronary Artery Disease

Lee Herman, James Froelich, Dino Kanelos, Robert St. Amant, May Yau, Brian Rhees, Mark Monane and John McPherson
The Journal of the American Board of Family Medicine March 2014, 27 (2) 258-267; DOI: https://doi.org/10.3122/jabfm.2014.02.130155
Lee Herman
From Johns Creek Primary Care, Suwanee, GA (LH); Family Care Clinic, Bonham, TX (JF); Carolina Family Healthcare, Weddington, NC (DK); The Lipid Center, Baton Rouge, LA (RS); CardioDx, Inc., Palo Alto, CA (MY, BR, MM); and Vanderbilt University, Nashville, TN (JM).
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James Froelich
From Johns Creek Primary Care, Suwanee, GA (LH); Family Care Clinic, Bonham, TX (JF); Carolina Family Healthcare, Weddington, NC (DK); The Lipid Center, Baton Rouge, LA (RS); CardioDx, Inc., Palo Alto, CA (MY, BR, MM); and Vanderbilt University, Nashville, TN (JM).
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Dino Kanelos
From Johns Creek Primary Care, Suwanee, GA (LH); Family Care Clinic, Bonham, TX (JF); Carolina Family Healthcare, Weddington, NC (DK); The Lipid Center, Baton Rouge, LA (RS); CardioDx, Inc., Palo Alto, CA (MY, BR, MM); and Vanderbilt University, Nashville, TN (JM).
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Robert St. Amant
From Johns Creek Primary Care, Suwanee, GA (LH); Family Care Clinic, Bonham, TX (JF); Carolina Family Healthcare, Weddington, NC (DK); The Lipid Center, Baton Rouge, LA (RS); CardioDx, Inc., Palo Alto, CA (MY, BR, MM); and Vanderbilt University, Nashville, TN (JM).
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May Yau
From Johns Creek Primary Care, Suwanee, GA (LH); Family Care Clinic, Bonham, TX (JF); Carolina Family Healthcare, Weddington, NC (DK); The Lipid Center, Baton Rouge, LA (RS); CardioDx, Inc., Palo Alto, CA (MY, BR, MM); and Vanderbilt University, Nashville, TN (JM).
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Brian Rhees
From Johns Creek Primary Care, Suwanee, GA (LH); Family Care Clinic, Bonham, TX (JF); Carolina Family Healthcare, Weddington, NC (DK); The Lipid Center, Baton Rouge, LA (RS); CardioDx, Inc., Palo Alto, CA (MY, BR, MM); and Vanderbilt University, Nashville, TN (JM).
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Mark Monane
From Johns Creek Primary Care, Suwanee, GA (LH); Family Care Clinic, Bonham, TX (JF); Carolina Family Healthcare, Weddington, NC (DK); The Lipid Center, Baton Rouge, LA (RS); CardioDx, Inc., Palo Alto, CA (MY, BR, MM); and Vanderbilt University, Nashville, TN (JM).
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John McPherson
From Johns Creek Primary Care, Suwanee, GA (LH); Family Care Clinic, Bonham, TX (JF); Carolina Family Healthcare, Weddington, NC (DK); The Lipid Center, Baton Rouge, LA (RS); CardioDx, Inc., Palo Alto, CA (MY, BR, MM); and Vanderbilt University, Nashville, TN (JM).
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    Figure 1.

    Patient screening, enrollment, and follow-up flowchart. CAD, coronary artery disease; GES, gene expression score.

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    Figure 2.

    Treatment decision before and after gene expression testing. GES, gene expression score.

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    Table 1. Clinical Characteristics of the Study Patients (n = 251)
    CharacteristicsPatients
    Clinical factors
        Female sex140 (56)
        Age (years)56.2 ± 13
        Non-Hispanic white ethnicity224 (89)
    Presenting symptoms
        Typical angina31 (12)
        Atypical angina67 (27)
        Noncardiac chest pain56 (22)
        Shortness of breath50 (20)
        Malaise/fatigue47 (19)
    Cardiac risk factors
        Hypertension120 (48)
        Dyslipidemia146 (58)
        Body mass index29.7 ± 6.7
        Systolic/diastolic blood pressure (mm Hg)128/79
    Gene expression score16.0 ± 10.0
    • Data are n (%) or mean ± standard deviation unless otherwise indicated.

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    Table 2. Association of Testing Changes Among Patients with Low and Elevated Gene Expression Scores
    Testing IntensityScore ClassAll
    ≤15>15
    Decreased76 (60)17 (14)93
    No change48 (38)58 (47)106
    Increased3 (2)49 (39)52
    All127 (100)124 (100)251
    • Data are n (%). P <.00001, exact test.

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The Journal of the American Board of Family     Medicine: 27 (2)
The Journal of the American Board of Family Medicine
Vol. 27, Issue 2
March-April 2014
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Utility of a Genomic-based, Personalized Medicine Test in Patients Presenting With Symptoms Suggesting Coronary Artery Disease
Lee Herman, James Froelich, Dino Kanelos, Robert St. Amant, May Yau, Brian Rhees, Mark Monane, John McPherson
The Journal of the American Board of Family Medicine Mar 2014, 27 (2) 258-267; DOI: 10.3122/jabfm.2014.02.130155

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Utility of a Genomic-based, Personalized Medicine Test in Patients Presenting With Symptoms Suggesting Coronary Artery Disease
Lee Herman, James Froelich, Dino Kanelos, Robert St. Amant, May Yau, Brian Rhees, Mark Monane, John McPherson
The Journal of the American Board of Family Medicine Mar 2014, 27 (2) 258-267; DOI: 10.3122/jabfm.2014.02.130155
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