CARDIO inCode-Score is a genetic test to evaluate the risk of coronary heart disease.
Genetics provides approximately a 50% risk contribution to the development of coronary heart disease and related major adverse cardiovascular events, e.g. myocardial infarction or heart attack (Zdravkovic et al., 2002; Wienke et al., 2005; Elosua et al., 2009; Roberts R, 2018). As a result, genetics is now recognised as a vitally important risk factor to be included in the patient risk assessment of coronary heart disease.
There is a direct and linear relationship between genetic load and the risk of a coronary event, both the incidence of the event and recurrence (Lluis-Ganella et al., 2010; Lluis-Ganella et al., 2012; Mega et al., 2015; Natarajan et al., 2017; Rincón et al., 2020; Marston et al., 2020; Damask et al., 2020; Emdin et al., 2020).
A significant proportion of cardiovascular events take place in individuals clinically classified in low or intermediate risk groups based on traditional (non-genetic) cardiovascular risk factors (Marrugat et al., 2011; Iribarren et al., 2016).
Genetic risk assessment in addition to clinical risk provides a comprehensive cardiovascular lifetime risk assessment to identify patients at the highest overall risk of coronary heart disease. The combination of genetic and clinical risk enables a ‘personalised medicine’ approach to preventing cardiovascular disease through lifestyle change, treatment therapy and/or new therapeutic goals.
CARDIO inCode-Score measures an individuals genetic risk of coronary heart disease. Taking an individual’s genetic risk into consideration enables physicians to reclassify patients into a higher risk category. It is estimated that 5% of patients clinically classified in the low-risk group and 14% of those in the intermediate-risk group would be reclassified to higher risk categories (Iribarren et al., 2016) where genetic risk is assessed.
CARDIO inCode-Score analyzes 12 Single Nucleotide Polymorphisms (SNPs) using qPCR
- Individuals with classical cardiovascular risk factors
- Individuals with other risk factors (overweight or obesity, hypertriglyceridemia, etc.)
- Individuals with intermediate/moderate 10-year cardiovascular risk
- Individuals with a family history of ischemic heart disease, especially if in first-degree relatives and/or at young ages (men <55 years and women <65 years)
- Individuals with a family history of a first-degree relative identified to have high genetic risk for coronary artery disease (ex: sibling with a CARDIO inCode-Score result showing high genetic risk or in quintile 5)
- Individuals looking for more cardiovascular genetic risk information as part of a general medical check-up
- Facilitate cardiovascular risk assessment
- Adjust cardiovascular risk assessment based on traditional clinical risk assessment tools (Framingham, Pooled Cohort Equation, etc.), particularly for those who fall in the borderline or intermediate risk groups
Numerous scientific articles published in prestigious national and international journals have been written about CARDIO inCode® Score:
- Rincón LM et al. A genetic risk score predicts recurrent events after myocardial infarction in young adults. Rev Eep Cardiol 2020;73(8):623-631. doi:/10.1016/j.rec.2019.08.006.
- Iribarren C et al. Weighted multi-marker genetic risk scores for incident coronary heart disease among individuals of African, Latino and East-Asian ancestry. Scientific Reports 2018;8:6853
- Iribarren C et al. Clinical utility of multimarker genetic risk scores for prediction of incident heart disease. A cohort study among over 51000 individuals of European ancestry. Circ Cardiovasc Genet 2016;9:531-540
- Doménech M et al. Awareness of genetic coronary risk score improves blood pressure control in hypertensive patients. Rev Esp Cardiol 2016;69(12):1119-1240
- Ramírez de Arellano A et al. Economic evaluation of Cardio inCode®, a clinical-genetic function for coronary heart disease risk assessment. Appl Health Econ Health Policy 2013;11:531-542
- Lluis-Ganella C et al. Assessment of the value of a genetic risk score in improving the estimation of coronary risk. Atherosclerosis 2012;222:456-463
- Lluis-Ganella C et al. Additive effects of multiple genetic variants on the risk of coronary artery disease. Rev Esp Cardiol 2010;63(8):925-33.
- Marston et al., 2020. Predicting Benefit from Evolocumab therapy in patients with atherosclerotic disease using a genetic risk score: Results from the FOURIER trial. Circulation 2020;141(8):616-623
- Damask et al, 2020. Patients with high genome-wide polygenic risk scores for coronary artery disease may receive greater clinical benefit from Alirocumab treatment in the ODYSSEY OUTCOMES trial. Circulation 2020;141:624-636
- Emdin et al., 2020. Genome-wide polygenic score and cardiovascular outcomes with evacetrapib in patients with high-risk vascular disease: A nested case-control study. Circ Genom Precis Med 2020;13:e002767
- Roberts R, 2018. Genetic risk stratification. Tipping point for global primary prevention of coronary artery disease. Circulation 2018;137:2554-2556
- Natarajan et al., 2017. Polygenic risk score identifies subgroup with higher burden of atherosclerosis and greater relative benefit from statin therapy in the primary prevention setting. Circulation 2017 May 30;135(22):2091-2101
- Mega et al, 2015. Genetic risk, coronary heart disease events, and the clinical benefit of statin therapy. Lancet 2015 June 6;385(9984):2264-2271
- Marrugat et al, 2011. Validez relativa de la estimación del riesgo cardiovascular a 10 años en una cohorte poblacional del estudio REGICOR. Rev Esp Cardiol 2011;64:385-94
- Elosua et al., 2009. Estudio del componente genético de la cardiopatía isquémica: de los estudios de ligamiento al genotipado integral del genoma. Rev Esp Cardiol Supl 2009;9:24B-38B
- Wienke et al., 2005. The heritability of CHD mortality in Danish twins after controlling for smoking and BMI. Twin Res Hum Genet 2005;8:53-59
- Zdravkovic et al., 2002. Heritability of death from coronary heart disease: a 36-year follow-up of 20,966 Swedish twins. J Intern Med 2002;252:247-254