1. Potential Role of Donor-Derived Cell Free DNA as a New Biomarker in Cardiac Allograft Vasculopathy (FreeDNA-CAV).
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Jimenez-Blanco Bravo, M., Perez Gomez, L., Arellano Serrano, C., Torres Sanabria, M., Hernandez Perez, F., Oteo Dominguez, J., Mingo Santos, S., Mitroi, C., Moñivas Palomero, V., Gomez Bueno, M., and Segovia Cubero, J.
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CORONARY artery stenosis , *TROPONIN I , *DNA , *RECEIVER operating characteristic curves , *CORONARY angiography - Abstract
There is an unmet need for a noninvasive biomarker for cardiac allograft vasculopathy (CAV), that could obviate the need to perform surveillance coronary angiograms in HT recipients. Donor-derived cell free DNA (ddcf-DNA) has shown a good ability to rule out cellular rejection, but its performance as a biomarker for CAV has not been tested. We sought to evaluate the performance of ddcf-DNA as a biomarker of CAV in a cohort of patients undergoing routine coronariography. We prospectively obtained ddcf-DNA levels in all patients who underwent routine coronary angiography >1 year after HT in our center between Jan and Sept 2019. Patients with concomitant acute rejection (n=5) or multi organ transplant (n=8) were excluded. Ddcf-DNA levels were correlated with CAV degree (ISHLT 2010 classification). We included 54 HT recipients (mean age 57 years, 70% men), with a mean of 10.2 years (IQR 4.3-16.9) after transplant. Coronary angiogram showed CAV 0 in 59%, CAV 1 in 22%, CAV 2 in 6% and CAV 3 in 13% (41% of patients with any degree of CAV). Median ddcf-DNA values for each CAV group are shown in figure 1A. Median levels did not differ significantly between patients with and without CAV: 0.64% in CAV 0 (IQR 0.19-1.26) as compared to 0.525% (IQR 0.12-1.8) in CAV 1, 2 or 3, p=0.94. Area under the ROC curve for CAV diagnosis was 0.51 (Figure 1B). No significant differences were found between patients with "stable CAV" (no new significant coronary lesions since previous angiogram, n=39) and "progressive CAV" (presence of new coronary stenosis, n=15): median values were 0.5% (IQR 0.17-1.1) and 0.87% (IQR 0.12-4.2) respectively, p=0.51. No correlation was found between ddcf-DNA and Troponin I (r=0.03, p=0.86) or NTproBNP levels (r=-0.09, p=0.59). In this preliminary experience, ddcf-DNA level did not seem to correlate with CAV, although sample size might be too small to reach definite conclusions. We hope that the ongoing recruiting (n=100) will shed light in this matter. [ABSTRACT FROM AUTHOR]
- Published
- 2020
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