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CARDIO inCode-Score is a genetic test to evaluate the risk for having a cardiovascular event.

Genetics make a 50% contribution to the development of cardiovascular events (Zdravkovic et al., 2002; Wienke et al., 2005; Elosua et al., 2009; Roberts R, 2018), and there is a direct, linear association between the genetic load and the risk of coronary events (both incident and recurrent) (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 events take place in individuals classified in the low and moderate risk groups based on classical cardiovascular risk factors (Marrugat et al., 2011; Iribarren et al., 2016).

The inclusion of the genetic load in the clinical assessment makes it possible to attain a more accurate and reliable overall cardiovascular risk score, and identify those patients at highest risk, who may need adjustments to their therapy and therapeutic goals.

With CARDIO inCode-Score, 5% of patients in the low-risk group and 14% of those in the moderate-risk group are reclassified to higher risk categories (Iribarren et al., 2016).

GENES ANALYZED

CARDIO inCode-Score analyzes 12 Single Nucleotide Polymorphisms (SNPs) using qPCR

INDICATIONS FOR TESTING
  • 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
CLINICAL UTILITY
  • 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
ORDERING DETAILS

Test Requisition Form (TRF)

Turnaround Time:      2-4 weeks*

Preferred Specimen:  2-5mL whole blood in EDTA tube (Lavender top); buccal (cheek) swabs are also accepted.

*TAT listed is an average and includes the time from when the sample arrives in the laboratory until the completed results report is sent to the ordering provider

ADDITIONAL INFORMATION

How is the CARDIO inCode-Score Polygenic Risk Score for CAD reported? 

Results classify a person’s risk as low, intermediate, or high according to quintiles. Low risk = results falling in quintile 1. Intermediate risk results falling in quintiles 2-4. High risk = results falling into quintile 5.

Has the CARDIO inCode-Score Polygenic Risk Score for CAD been validated?

Yes. The CARDIO inCode-Score Polygenic Risk Score for CAD has been validated in more than 80,000 individuals of different population origins (Spanish, European Americans, Latin Americans, African Americans, and Asians). It has been shown to be independent of classical, clinical risk factors for CAD and contributes approximately 50% of the risk for a cardiovascular event.

Does the CARDIO inCode-Score Polygenic Risk Score for CAD include or incorporate risk for hyperlipidemia?

No. The CARDIO inCode-Score Polygenic Risk Score for CAD does not include any SNPs known to drive risk for HLD. GENinCode provides a separate Polygenic Risk Score for High LDL (included on the LIPID inCode test) to assess risk for HLD. The SNPs included on this test are known to specifically contribute to risk for CAD, independent of HLD. As such, it is considered as applicable to assessing an individual’s genetic risk for CAD whether or not they have a personal history of HLD. The resulting risk has also been shown to be independent of other classical cardiovascular risk factors.

BIBLIOGRAPHY

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.
REFERENCES IN THE TEXT
  • 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

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