Frontiers in Cardiovascular Medicine (Apr 2022)

Lack of Usefulness of Donor-Derived Cell-Free DNA as a Biomarker for Cardiac Allograft Vasculopathy: A Prospective Study

  • Marta Jiménez-Blanco Bravo,
  • Marta Jiménez-Blanco Bravo,
  • Marta Jiménez-Blanco Bravo,
  • Laura Pérez-Gómez,
  • Laura Pérez-Gómez,
  • Francisco J. Hernández-Pérez,
  • Carlos Arellano-Serrano,
  • Mario Torres-Sanabria,
  • Manuel Gómez-Bueno,
  • Manuel Gómez-Bueno,
  • Juan F. Oteo-Domínguez,
  • Susana Mingo-Santos,
  • Javier Segovia-Cubero,
  • Javier Segovia-Cubero

DOI
https://doi.org/10.3389/fcvm.2022.856600
Journal volume & issue
Vol. 9

Abstract

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BackgroundCardiac allograft vasculopathy (CAV) remains a major cause of morbidity and mortality among long-term heart transplant recipients. There is an unmet need for a non-invasive biomarker of CAV that could obviate the need to perform surveillance coronary angiograms in these patients. Our aim was to evaluate the performance of Donor-derived Cell Free DNA (dd-cfDNA) as a biomarker of CAV.MethodsWe prospectively measured dd-cfDNA levels in all patients undergoing routine coronary angiography >1 year after heart transplant at a single center. Endpoints included the association between dd-cfDNA levels and the presence CAV, according to several prespecified criteria.ResultsWe included 94 heart transplant recipients, a median of 10.9 years after transplant. Coronary angiogram revealed CAV0, CAV1, CAV2, and CAV3 in 61, 19, 14, and 6% of patients, respectively. Comparison of dd-cfDNA levels in patients with CAV0 and CAV1–2–3 (primary end-point) did not show significant differences (0.92%, IQR 0.46–2.0 vs. 0.46%, IQR 0.075–1.5, p = 0.059), nor did the comparison between patients with stable CAV (no new coronary lesions since previous angiogram, n = 77) and progressive CAV (n = 17); dd-cfDNA values 0.735% (IQR 0.195–2.0) vs. 0.9% (IQR 0.12–1.8), p = 0.76. However, we found an association between NTproBNP levels and CAV degree (p = 0.017). Dd-cfDNA levels did not correlate with NTproBNP (ρ = −0.095).ConclusionIn this study, dd-cfDNA did not perform as a useful biomarker to avoid surveillance coronary angiograms for CAV diagnosis.Clinical Trial NotationPotential Role of Donor-derived Cell Free DNA as a Biomarker in Cardiac Allograft Vasculopathy, NCT 04791852.

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