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Atherosclerosis. 2014 Mar;233(1):284-90. doi: 10.1016/j.atherosclerosis.2013.12.045. Epub 2014 Jan 20.

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.

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Stony Brook University, Stony Brook, NY, USA.
CardioDx, Inc., 2500 Faber Place, Palo Alto, CA 94303, USA.
Harbor UCLA Medical Center, Torrance, CA, USA.
Long Beach Memorial Medical Center, Long Beach, CA, USA; University of California, Irvine, Orange, CA, USA.
CardioDx, Inc., 2500 Faber Place, Palo Alto, CA 94303, USA. Electronic address:



We previously validated a gene expression score (GES) based on age, sex and peripheral blood cell expression levels of 23 genes measured by quantitative real-time PCR (qRT-PCR) for diagnosis of obstructive coronary artery disease (CAD) (≥ 50% luminal diameter stenosis). In this study we sought to determine the association between the GES and coronary arterial Plaque Burden and Stenosis by CT-angiography.


A total of 610 patients (mean age: 57 ± 11; 50% male) from the PREDICT and COMPASS studies from 59 centers were analyzed. Coronary artery calcium (CAC) scoring, CT angiography (CTA)-based plaque and stenosis and GES measurements were performed. CAC was expressed as Agatston score and CTA evaluated for stenosis severity: 0. None; 1. Minimal, 2. Mild, 3. Moderate, 4. Severe and 5. Occluded. Correlation analysis, one-way analysis of variance (ANOVA) and receiver operating characteristics (ROC) analyses were performed.


GES was significantly associated with plaque burden by CAC (r = 0.50; p < 0.001) and CTA (segment involvement score index: r = 0.37, p < 0.001); a low score (≤ 15) had sensitivity of 0.71 and a high score (≥ 28) a specificity of 0.97 for the prediction of zero vs. non-zero CAC. Increasing GES was associated with a greater degree of categorical stenosis by ANOVA (p < 0.001); GES significantly correlated with maximum luminal stenosis (r = 0.41; p < 0.01) and segment stenosis score index (r = 0.38; p < 0.01). A low score had sensitivity of 0.90 and a high score a specificity of 0.87 for ≥ 70% stenosis.


A previously validated GES is significantly associated with Plaque Burden and Stenosis by CT.


(PREDICT [NCT00500617] and COMPASS [NCT01117506]),


CT-angiography; Calcium score; Coronary artery disease; Gene expression; Plaque burden

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