Personalized Risk Evaluation and Diagnosis (Using Corus CAD or ASGES) in the Coronary Tree

NCT ID: NCT00500617

Last Updated: 2019-01-31

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Total Enrollment

4350 participants

Study Classification

OBSERVATIONAL

Study Start Date

2007-07-31

Study Completion Date

2011-09-30

Brief Summary

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The PREDICT study is to develop and validate a diagnostic blood ASGES (age, sex, gene expression score) or Corus CAD for atherosclerotic coronary artery disease (CAD). The Corus CAD (Age/Sex/Gene Expression score - ASGES) will use quantitative real-time PCR (RT-PCR) to quantify the expression of multiple genes from circulating peripheral blood cells to assess the presence of clinically significant CAD in a patient.

Detailed Description

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The purpose of the PREDICT study is to develop and validate a diagnostic blood ASGES (age, sex, gene expression score) or Corus CAD for atherosclerotic coronary artery disease (CAD). The Corus CAD (Age/Sex/Gene Expression score - ASGES) will use quantitative real-time PCR (RT-PCR) to quantify the expression of multiple genes from circulating peripheral blood cells to assess the presence of clinically significant CAD in a patient.

This is a prospective, multi-center, observational study. Participation in the study does not alter clinical care. The only procedure required by the protocol is collection of a research blood sample. All other data collected will be in accordance with each participating institution's standard patient care.

The study is divided into four sequential segments with unique subjects and goals: ASGES (Corus CAD) discovery (segment 1), ASGES (Corus CAD) development (segment 2), ASGES (Corus CAD) validation (segment 3), and additional ASGES (Corus CAD) testing (segment 4). The primary analysis will be performed during the third segment of the study using a subset of the enrolled subjects ("primary subjects"). Primary subjects will be defined by additional eligibility criteria beyond the general eligibility criteria required for enrollment in the overall study. The additional, post-enrollment eligibility criteria will be based on clinical and demographic factors that are found during the course of the study to affect the expression of genes used in the ASGES (Corus CAD). Such factors will be identified during gene discovery and algorithm development. The post-enrollment eligibility criteria will be defined prior to the beginning of the ASGES (Corus CAD) validation segment of the study.

In addition, three substudies are planned and will enroll up to 1500 subjects.

* The first substudy will include subjects undergoing cardiac CT angiography (CTA) and aims to determine how gene expression correlates with total coronary atheroma burden, as measured by CTA.
* The second substudy examines sample handling and shipping conditions and does not affect the treatment of the subjects.
* The third substudy will focus on additional algorithm development and validation in a non-diabetic female patient population.

Conditions

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Coronary Artery Disease Angina Pectoris Chest Pain Cardiovascular Diseases Coronary Heart Disease CAD CVD CHD

Study Design

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Observational Model Type

OTHER

Study Time Perspective

PROSPECTIVE

Study Groups

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segment 1

Gene discovery blood draw

Corus CAD (ASGES)

Intervention Type DIAGNOSTIC_TEST

Age/Sex/Gene Expression Score - ASGES

sement 2

Assay development blood draw

Corus CAD (ASGES)

Intervention Type DIAGNOSTIC_TEST

Age/Sex/Gene Expression Score - ASGES

segment 3

Assay validation blood draw

Corus CAD (ASGES)

Intervention Type DIAGNOSTIC_TEST

Age/Sex/Gene Expression Score - ASGES

segment 4

Additional assay testing blood draw (Note: post discovery diabetic subjects assigned to this group)

Corus CAD (ASGES)

Intervention Type DIAGNOSTIC_TEST

Age/Sex/Gene Expression Score - ASGES

Interventions

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Corus CAD (ASGES)

Age/Sex/Gene Expression Score - ASGES

Intervention Type DIAGNOSTIC_TEST

Eligibility Criteria

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Inclusion Criteria

* Referral for a coronary angiogram (either invasive X-ray angiography or coronary CTA)
* Any one of the following clinical syndromes:

1. chest pain syndrome, stable angina, or anginal equivalent suggesting myocardial ischemia
2. low-risk unstable angin, or
3. asymptomatic individuals with a high probability of CAD

Exclusion Criteria

* History of myocardial infarction or known CAD
* Current Myocardial Infarct (MI), acute coronary syndrome with high-risk features or unstable angina with high-risk features
* New York Heart Association (NYHA) class III or IV congestive
* Inability to give informed congestive heart failures
* Severe left ventricular systolic dysfunction (LVEF\<35%)
* Severe regurgitant or stenotic cardiac valve lesion
* Active or chronic systemic infection
* Rheumatologic, autoimmune or hematologic conditions
* Any organ transplant
* Immunosuppressive therapy
* Chemotherapy in the preceding year
* Major blood or blood product transfusion in the preceding 2 months
Minimum Eligible Age

21 Years

Maximum Eligible Age

99 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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CardioDx

INDUSTRY

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Mark Monane, MD FACP CMQ

Role: STUDY_CHAIR

CardioDx

Locations

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Alaska Heart Institute

Anchorage, Alaska, United States

Site Status

CV Medical Group Southern California

Beverly Hills, California, United States

Site Status

Scripps HealthCare

La Jolla, California, United States

Site Status

Washington Hospital Medical Center

Washington D.C., District of Columbia, United States

Site Status

Fuqua Heart Center of Atlanta

Atlanta, Georgia, United States

Site Status

Minneapolis Heart Institute

Minneapolis, Minnesota, United States

Site Status

Duke University Medical Center

Durham, North Carolina, United States

Site Status

Allegheny Hospital

Pittsburgh, Pennsylvania, United States

Site Status

Vanderbilt University Medical Center

Nashville, Tennessee, United States

Site Status

Intermountain HealthCare

Salt Lake City, Utah, United States

Site Status

Countries

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United States

References

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Rosenberg S, Elashoff MR, Beineke P, Daniels SE, Wingrove JA, Tingley WG, Sager PT, Sehnert AJ, Yau M, Kraus WE, Newby LK, Schwartz RS, Voros S, Ellis SG, Tahirkheli N, Waksman R, McPherson J, Lansky A, Winn ME, Schork NJ, Topol EJ; PREDICT (Personalized Risk Evaluation and Diagnosis in the Coronary Tree) Investigators. Multicenter validation of the diagnostic accuracy of a blood-based gene expression test for assessing obstructive coronary artery disease in nondiabetic patients. Ann Intern Med. 2010 Oct 5;153(7):425-34. doi: 10.7326/0003-4819-153-7-201010050-00005.

Reference Type RESULT
PMID: 20921541 (View on PubMed)

Voros S, Elashoff MR, Wingrove JA, Budoff MJ, Thomas GS, Rosenberg S. A peripheral blood gene expression score is associated with atherosclerotic Plaque Burden and Stenosis by cardiovascular CT-angiography: results from the PREDICT and COMPASS studies. Atherosclerosis. 2014 Mar;233(1):284-90. doi: 10.1016/j.atherosclerosis.2013.12.045. Epub 2014 Jan 20.

Reference Type RESULT
PMID: 24529158 (View on PubMed)

Beineke P, Fitch K, Tao H, Elashoff MR, Rosenberg S, Kraus WE, Wingrove JA; PREDICT Investigators. A whole blood gene expression-based signature for smoking status. BMC Med Genomics. 2012 Dec 3;5:58. doi: 10.1186/1755-8794-5-58.

Reference Type RESULT
PMID: 23210427 (View on PubMed)

Lansky A, Elashoff MR, Ng V, McPherson J, Lazar D, Kraus WE, Voros S, Schwartz RS, Topol EJ. A gender-specific blood-based gene expression score for assessing obstructive coronary artery disease in nondiabetic patients: results of the Personalized Risk Evaluation and Diagnosis in the Coronary Tree (PREDICT) trial. Am Heart J. 2012 Sep;164(3):320-6. doi: 10.1016/j.ahj.2012.05.012. Epub 2012 Jul 24.

Reference Type RESULT
PMID: 22980297 (View on PubMed)

Rosenberg S, Elashoff MR, Lieu HD, Brown BO, Kraus WE, Schwartz RS, Voros S, Ellis SG, Waksman R, McPherson JA, Lansky AJ, Topol EJ; PREDICT Investigators. Whole blood gene expression testing for coronary artery disease in nondiabetic patients: major adverse cardiovascular events and interventions in the PREDICT trial. J Cardiovasc Transl Res. 2012 Jun;5(3):366-74. doi: 10.1007/s12265-012-9353-z. Epub 2012 Mar 7.

Reference Type RESULT
PMID: 22396313 (View on PubMed)

Elashoff MR, Wingrove JA, Beineke P, Daniels SE, Tingley WG, Rosenberg S, Voros S, Kraus WE, Ginsburg GS, Schwartz RS, Ellis SG, Tahirkheli N, Waksman R, McPherson J, Lansky AJ, Topol EJ. Development of a blood-based gene expression algorithm for assessment of obstructive coronary artery disease in non-diabetic patients. BMC Med Genomics. 2011 Mar 28;4:26. doi: 10.1186/1755-8794-4-26.

Reference Type RESULT
PMID: 21443790 (View on PubMed)

Daniels SE, Beineke P, Rhees B, McPherson JA, Kraus WE, Thomas GS, Rosenberg S. Biological and analytical stability of a peripheral blood gene expression score for obstructive coronary artery disease in the PREDICT and COMPASS studies. J Cardiovasc Transl Res. 2014 Oct;7(7):615-22. doi: 10.1007/s12265-014-9583-3. Epub 2014 Aug 14.

Reference Type DERIVED
PMID: 25119856 (View on PubMed)

Other Identifiers

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PREDICT

Identifier Type: OTHER

Identifier Source: secondary_id

CDX_000004

Identifier Type: -

Identifier Source: org_study_id

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