The test, announced Wednesday by doctors at Duke, is being developed after the discovery of genetic markers that show the presence and intensity of blockage in coronary artery disease, said a Duke cardiologist who co-authored research on the link.

Such a blood test could save millions of dollars annually by allowing some patients to avoid risky procedures in which catheters are inserted into patients' arteries.

"I think it is a big deal," Dr. William E. Kraus, a Duke cardiologist, said in an interview Wednesday. "What we want is a test that tells us the status of your disease today and if what you have is heart disease." Kraus' research was published in the medical journal Circulation: Cardiovascular Genetics.

Current detection of the disease -- the leading cause of death in the United States and a top killer in North Carolina, with 23,610 deaths in 2006 -- can require expensive tests such as echocardiograms, stress tests and imaging techniques that use radiation.

"A blood-based test to diagnose coronary artery disease would be less invasive and risky and would prevent patients from [receiving] radiation exposure," Kraus said in a statement.

Raleigh retiree Robert Sharpe said going directly from a blood test to having a catheter inserted would have been an improvement over what he went through before two recent heart surgeries.

"It would have been a whole lot easier," said Sharpe, 74, who now stays in shape at the Institute of Lifestyle & Weight Management in Raleigh. "I had a stress test and all of that."

The finding that 14 specific genes tend to accompany the narrowing of arteries arose from research by Duke and CardioDx, a molecular-diagnostics company in California that helped fund the study. It's based on the examination of genes in 41 heart patients, some from Germany and some from Duke.

Together, the 14 genes form a "signature" that indicates the presence of coronary artery disease, but may not be a cause or effect of the disease, researchers said.

Two Triangle cardiologists not involved in the research said it looks promising, but noted the small number of cases involved. Patients from a variety of backgrounds will be tested in larger trials under way at 28 sites across the United States.

"If these findings hold for this broad group of population, the test could prove to be a valuable supplement in our management and treatment of patients with coronary heart disease," said Dr. Sidney Smith, a UNC-Chapel Hill cardiologist.

Dr. Joe Falsone, an invasive cardiologist at Wake Heart & Vascular Associates, called the discovery "potentially exciting news."

"We could probably use this as a screening tool for patients we thought were at high risk," Falsone said.

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