Parvovirus B19 at the culprit coronary stenosis predicts outcome after stenting

Giampaolo Niccoli, Anna Severino, Maurizio Pieroni, Nicola Cosentino, Maria A. Ventrone, Micaela Conte, Marco Roberto, Giorgio Gallinella, Giovanna Liuzzo, Antonio M. Leone, Italo Porto, Francesco Burzotta, Carlo Trani, Filippo Crea

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Abstract

Background: Parvovirus (PV) B19 DNA is detected in endothelial cells and may cause endothelial dysfunction, which is involved in in-stent restenosis. We aimed at performing an exploratory analysis that evaluated if PVB19 DNA at the culprit coronary stenosis would be associated with an increased rate of major adverse cardiac events (MACE) after coronary stenting. Materials and methods: Consecutive patients undergoing stent implantation for stable or unstable coronary artery disease were enroled. Serology for PVB19 infection and presence of DNA for PVB19 on balloons used for predilatation were assessed in all patients. MACE rate, as a composite of cardiac death, myocardial infarction (MI) or clinically driven target lesion revascularization (TLR) was obtained at 24 month follow-up. Adjusted hazard ratio (HR) with 95% confidence interval (CI) was calculated for variables associated with MACE. Results: One hundred and nine patients [age 66 ± 10, male sex 89 (82%)] were enroled. At 24-month follow-up, 18 patients experienced a MACE. Two patients (2%) experienced MI, while 16 patients (15%) experienced clinically driven TLR. At multiple Cox regression analysis, the presence of PVB19 DNA on the balloon and the use of bare-metal stents were independent predictors of MACE [HR 3·30, 95% CI (1·12-10·08), P = 0·03 and HR 4·19, 95% CI (1·60-10·94), P = 0·003]. Conclusions: PVB19 DNA detected on the balloon used for dilatation of coronary stenosis before stent implantation is associated with MACE rate at follow-up, mainly due to clinically driven TLR. The results of this exploratory analysis should be confirmed in a larger population.

Original languageEnglish
Pages (from-to)209-218
Number of pages10
JournalEuropean Journal of Clinical Investigation
Volume44
Issue number2
DOIs
Publication statusPublished - Feb 2014

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Keywords

  • Coronary stent
  • In-stent restenosis
  • Parvovirus B19
  • Target lesion revascularization

ASJC Scopus subject areas

  • Medicine(all)
  • Clinical Biochemistry
  • Biochemistry

Cite this

Niccoli, G., Severino, A., Pieroni, M., Cosentino, N., Ventrone, M. A., Conte, M., Roberto, M., Gallinella, G., Liuzzo, G., Leone, A. M., Porto, I., Burzotta, F., Trani, C., & Crea, F. (2014). Parvovirus B19 at the culprit coronary stenosis predicts outcome after stenting. European Journal of Clinical Investigation, 44(2), 209-218. https://doi.org/10.1111/eci.12223