Early detection key with coronary artery disease
Heart disease is the nation’s leading cause of death, according to the Centers for Disease Control,.
Heart disease, also know as coronary artery disease (CAD), is caused by plaque build-up in the arteries that supply blood to the heart. It can result in irregular heartbeat, chest pain and heart attack, which account for one out of every four deaths, the CDC says.
The good news is heart disease is both preventable and controllable with early detection.
While the signs of a heart attack can be dramatic, early signs of heart disease can be subtle and even mimic other conditions.
Dr. Robert St. Amant treats patients with lipid disorders that put them at risk for high cholesterol and other problems associated with cardiovascular disease.
“Primary care physicians often see patients who complain of some kind of discomfort in the chest or arm,” says St. Amant. Unstable patients who have a high risk of heart attack are referred immediately to a cardiologist.
But if the patient is not in distress, St. Amant says, the physician “has to figure out: Is this heartburn? Or is this problem related to the pulmonary or musculoskeletal system?”
For example, if a patient describes fatigue, indigestion or pain between the shoulders after moderate exercise, the physician first completes a history and physical exam and evaluates risk factors, such as family history, smoking, lipids, blood pressure, diet and weight.
If the doctor suspects heartburn, the patient might receive a trial of anti-acid medication and change his or her diet. If the problems persist, tests — ranging from X-rays and EKGs to stress tests and cardiac catheterization — are run to eliminate cardiac disease as the culprit and to identify the source of the problem.
While effective, that strategy can be time consuming and expensive.
Recently, St. Amant and Baton Rouge General Medical Center Bluebonnet enrolled patients in a nationwide study to investigate if a new blood test could predict whether additional cardiac testing is warranted.
“CORUS CAD is a rule-out test (for) the presence of an obstructive coronary disease, which is defined as stenosis — blockage — in one of the major coronary arteries of 50 percent or more,” explains St. Amant. “We do a CORUS test on (non-diabetic) adult men and women (when) the physician suspects the possibility of CAD due to the symptoms (patients) relate. “
CORUS is a gene expression test. It gives a snapshot of current gene activity rather than revealing a genetic characteristic, such as a mutation, that remain constant over a lifetime.
The test evaluates 23 different genes and weights the results by gender and age.
“We get a molecular and biological picture of the health of the arterial wall,” explains St. Amant. “It improves clinical decision-making as to whether or not significant heart disease is the cause of the patient’s problem.”
Since the study’s conclusion in 2013, the CORUS CAD has been available in 14 states, including Louisiana.
If a physician suspects a patient might have significant risk for early stages disease, the doctor sends off a blood sample to the California-based company.
Typically, the results are ready in 72 hours. A low score essentially eliminates CAD as a diagnosis; an intermediate or high score requires further diagnostics.
“The art of medicine is more than just science and there is no perfect test,” says St. Amant. “but this test helps us to make a diagnosis more efficiently, save health care dollars and save patient time. “