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IMPACT-PCP

The IMPACT-PCP (Investigation of a Molecular Personalized Coronary Gene Expression Test on Primary Care Practice Pattern) Trial

Purpose:

To measure the impact of the Corus CAD score on clinicians' care plans for patients presenting with chest pain or angina equivalent symptoms in the primary care setting.

Type:

Prospective

Size:

251 patients eligible for analysis.

Trial Design:

IMPACT-PCP1 was conducted by eight primary care clinicians from four U.S. practices using a pre- and post-trial design. The clinicians performed their initial assessment of the patient and recorded their preliminary patient management plan into one of the following categories: (1) no further cardiac testing or treatment; (2) medical management or lifestyle changes; (3) referral for coronary computed tomography angiography (CCTA) or stress testing with or without imaging, including myocardial perfusion imaging (MPI); or (4) referral for invasive coronary angiography. The clinicians then obtained a peripheral blood sample and ordered the Corus CAD test. After receiving the Corus CAD results, each clinician then decided on the appropriate evaluation and management of the patient using the Corus CAD score in conjunction with the information that was previously available. We measured both the percentage of time that clinicians changed their care plans and whether the change resulted in an increase or decrease in the intensity of testing.

Key Findings:

Clinicians changed their care plans for 58% of the patients (145/251). There was an overall reduction in testing across the patient population after clinicians received the Corus CAD scores. Low Corus CAD scores (≤15) generally corresponded with less intensive cardiac diagnostic evaluation or more intensive management, while elevated scores (>15) generally corresponded with no change in cardiac diagnostic evaluation or more intensive management.

Status:

Published, Journal of the American Board of Family Medicine (March 2014)1

Identifier:

NCT01594411

 

IMPACT-PCP Trial Results (n=251)

Clinicians Changed Patients' Care Plan 58% of the Time After Corus CAD Testing (p<0.001)

 

Patients With Downgraded Testing

Patients With No Change in Testing

Patients With Upgraded Testing

Corus CAD (≤15)

60%

(76/127)

38%

(48/127)

2%

(3/127)

Corus CAD (>15)

14%

(17/124)

47%

(58/124)

39%

(49/124)


  1. Herman L, Froelich J, Kanelos D, et al. Utility of a Genomic-based, Personalized Medicine Test in Patients Presenting With Symptoms Suggesting Coronary Artery Disease. J Am Board Fam Med. 2014;27(2):258-67.