BlueCross BlueShield of Tennessee Medical Policy Manual

Genotyping for 9p21 Single Nucleotide Polymorphisms to Predict Risk of Cardiovascular Disease or Aneurysm

DESCRIPTION

A number of highly correlated single nucleotide polymorphisms (SNPs) found in the chromosome 9 region p21 locus (9p21) have been investigated for association with myocardial infarction (MI), particularly early onset MI, and other manifestations of cardiovascular disease. Associations with abdominal aortic aneurysm and intracranial aneurysm have also been reported. Genotyping for 9p21 SNPs has been investigated to identify patients who may be at increased risk of cardiovascular disorders.

POLICY

IMPORTANT REMINDERS

ADDITIONAL INFORMATION  

There is insufficient evidence to support the clinical use of the 9p21 genetic variant to predict clinical events, or that its use improves health outcomes. Therefore, 9p21 genotyping for all applications is considered investigational.

SOURCES 

Abrantes, P., Santos, M., Sousa, I., Xavier, J., Francisco, V., Krug, T., et al. (2015). Genetic variants underlying risk of intracranial aneurysms: insights from a GWAS in Portugal. PloS One, 10 (7), e0133422. (Level 4 evidence)

Alg, V., Sofat, R., Houlden, H., & Werring, D. (2013). Genetic risk factors for intracranial aneurysms. A meta-analysis in more than 116,000 individuals. Neurology, 80, 2154-2165. (Level 1 evidence)

American College of Cardiology/American Heart Association. 2013 ACC/AHA guideline on the assessment of cardiovascular risk. Retrieved June 2, 2017 from http://www.onlinejacc.org/content/accj/63/25_Part_B/2935.full.pdf?_ga=2.185171625.1411743239.1496427944-2128906682.1496427944.

Chan, K., Patel, R., Newcombe, P., Nelson, C., Qasim, A., Epstein, S., et al. (2013). Association between the chromosome 9p21 locus and angiographic coronary artery disease burden: A collaborative meta-analysis. Journal of the American College of Cardiology, 61 (9), 957-970. (Level 1 evidence)

Dong, L., Wang, H., Wang, D., & Ding, H. (2013). Association of chromosome 9p21 genetic variants with risk of coronary heart disease in the East Asian population: a meta-analysis. Annuls of Human Genetics, 77, 183-190. (Level 1 evidence)

Guo, J., Li, W., Wu, Z., Cheng, X., Wang, Y., & Chen, T. (2013). Association between 9p21.3 genomic markers and coronary artery disease in East Asians: a meta-analysis involving 9,813 cases and 10,710 controls. Molecular Biology Reports, 40 (1), 337-343. Abstract retrieved June 2, 2017 from PubMed database.

Matoo, S., Fallah, M., Daneshpour, M., Mousavi, R., Sedaghati, K., Hasanzad, M., & Azizi, F. (2017). Increased risk of CHD in the presence of rs7865618 (A allele): Tehran lipid and glucose study. Archives of Iranian Medicine, 20 (3), 153-157. Abstract retrieved June 2, 2017 from PubMed database.

Patel, R., Asselbergs, F., Quyyumi, A., Palmer, T., Finan, C., Tragante, V., et al. (2014). Genetic variants at chromosome 9p21 and risk of first versus subsequent coronary heart disease events. Journal of the American College of Cardiology, 63 (21), 2234-2245. (Level 1 evidence)

ORIGINAL EFFECTIVE DATE:  12/8/2012

MOST RECENT REVIEW DATE:  7/13/2017

ID_BT

Policies included in the Medical Policy Manual are not intended to certify coverage availability. They are medical determinations about a particular technology, service, drug, etc. While a policy or technology may be medically necessary, it could be excluded in a member's benefit plan. Please check with the appropriate claims department to determine if the service in question is a covered service under a particular benefit plan. Use of the Medical Policy Manual is not intended to replace independent medical judgment for treatment of individuals. The content on this Web site is not intended to be a substitute for professional medical advice in any way. Always seek the advice of your physician or other qualified health care provider if you have questions regarding a medical condition or treatment.

This document has been classified as public information.