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

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

JOURNAL=Frontiers in Cardiovascular Medicine

VOLUME=Volume 9 - 2022

YEAR=2022

URL=https://www.frontiersin.org/journals/cardiovascular-medicine/articles/10.3389/fcvm.2022.856600

DOI=10.3389/fcvm.2022.856600

ISSN=2297-055X

ABSTRACT=Background: Cardiac allograft vasculopathy (CAV) remains a major cause of morbidity and mortality among long-term heart transplant recipients. There is an unmet need for a noninvasive 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. 

Methods: We 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.

Results: We 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 (rho= -0.095). 

Conclusion: In this study, dd-cfDNA did not perform as a useful biomarker to avoid surveillance coronary angiograms for CAV diagnosis.