BlueCross BlueShield of Tennessee Medical Policy Manual

KIF6 Genotyping for Predicting Cardiovascular Risk and/or Effectiveness of Statin Therapy

DESCRIPTION

Genetic testing to determine the KIF6 Trp719Arg variant status is being evaluated as a prognostic test to predict risk of future cardiovascular events and as a pharmacogenetic test to predict response to statin therapy, particularly in high-risk individuals. The intent of testing for kinesin-like protein 6 (KIF6) gene variants in individuals receiving statin therapy for coronary artery disease (CAD) is to inform a decision as to whether an individual who has a variant is at a higher risk of a future cardiovascular event, and therefore statin treatment should be initiated or the existing statin dose should be increased.

Kinesin-like protein 6 (KIF6) belongs to the kinesin superfamily of proteins involved in intracellular transport.  The exact function of the KIF6 gene is as yet undetermined.

POLICY

IMPORTANT REMINDERS

ADDITIONAL INFORMATION  

The literature that is currently available is limited and contradictory regarding outcomes. There is a lack of controlled studies in the published literature to evaluate the clinical importance of KIF6 genotyping to predict clinical events.

SOURCES 

BlueCross BlueShield Association. Medical Policy Reference Manual. (7:2017). KIF6 genotyping for predicting cardiovascular risk and/or effectiveness of statin therapy (2.04.67). Retrieved September 26, 2017 from BlueWeb. (26 articles and/or guidelines reviewed)

Cahaba Government Services Administrators, LLC. (2015, October) Local Coverage Article: MolDX: KIF6 Genotype Billing and Coding Guidelines (A54272). Retrieved September 26, 2017 from https://www.cms.gov.

Ference, B., Yoo, W., Flack, J., & Clarke, M. (2011). A common KIF6 polymorphism increases vulnerability to low-density lipoprotein cholesterol: two meta-analyses and a meta-regression analysis. PLoS One, 6 (12), e28834. (Level 2 evidence)

Hopewell, J., Parish, S., Clarke, R., Armitage, J., Bowman, L., Hager, J., et al. (2011). No impact of KIF 6 genotype on vascular risk and statin response among 18, 348 randomized patients in heart protection study. Journal of the American College of Cardiology, 57 (20), 2000-2007. (Level 1 Evidence)

Peng, P., Lian, J., Huang, S., Xu, L., Huang, Y., Ba, Y., et al. (2012, December) Meta-analyses of KIF6 Trp719Arg in coronary heart disease and statin therapeutic effect. PLOS One, 7 (12). (Level 2 evidence)

Rosticci, M., Marullo, L., Cicero, A., Magi, R., Fischer, K., Pervjakova, N., et al. (2015). 1A.11: Association of KIF6 and HMGCR loci with cardiometabolic phenotypes and response to statin therapy in the brisighella cohort. Journal of Hypertension, 33 suppl 1, e3-4. Abstract retrieved January 21, 2016 from PubMed database.

Ruiz-Ramos, D., Hernández-Díaz, Y., Tovilla-Zárate, C., Juárez-Rojop, I., López-Narváez, M., González-Castro, T., et al. (2015). The Trp719Arg polymorphism of the KIF6 gene and coronary heart disease risk: systematic review and meta-analysis. BioMed Central, 153 (3). (Level 2 evidence)

Vishnuprabu, D., Geetha, S., Bhaskar, L., Mahapatra, N., & Munirajan, A. (2015). Genotyping and meta-analysis of KIFG Trp719Arg polymorphism in South Indian coronary artery disease patients: a case-control study. Meta Gene, 5 (2015), 129-134. (Level 3 evidence)

ORIGINAL EFFECTIVE DATE:  10/8/2011

MOST RECENT REVIEW DATE:  11/9/2017

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