title: Parvovirus B19 at the culprit coronary stenosis predicts outcome after stenting.
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.
  
  
  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.
authors.affiliation: Institute of Cardiology, Catholic University of the Sacred Heart, Rome, Italy.
authors.forename: Giampaolo
authors.initials: G
authors.lastname: Niccoli
authors.forename: Anna
authors.initials: A
authors.lastname: Severino
authors.forename: Maurizio
authors.initials: M
authors.lastname: Pieroni
authors.forename: Nicola
authors.initials: N
authors.lastname: Cosentino
authors.forename: Maria A
authors.initials: MA
authors.lastname: Ventrone
authors.forename: Micaela
authors.initials: M
authors.lastname: Conte
authors.forename: Marco
authors.initials: M
authors.lastname: Roberto
authors.forename: Giorgio
authors.initials: G
authors.lastname: Gallinella
authors.forename: Giovanna
authors.initials: G
authors.lastname: Liuzzo
authors.forename: Antonio M
authors.initials: AM
authors.lastname: Leone
authors.forename: Italo
authors.initials: I
authors.lastname: Porto
authors.forename: Francesco
authors.initials: F
authors.lastname: Burzotta
authors.forename: Carlo
authors.initials: C
authors.lastname: Trani
authors.forename: Filippo
authors.initials: F
authors.lastname: Crea
mesh_terms: D000368:Aged; D063125:Balloon Embolectomy; D003324:Coronary Artery Disease / Q000628:therapy* / Q000821:virology; D023903:Coronary Restenosis / Q000821:virology*; D004279:DNA, Viral / Q000032:analysis*; D016757:Death, Sudden, Cardiac; D054855:Drug-Eluting Stents; D004866:Equipment Contamination; D005260:Female; D006801:Humans; D008297:Male; D009204:Myocardial Revascularization; D010322:Parvoviridae Infections / Q000150:complications*; D016732:Parvovirus B19, Human / Q000235:genetics*; D015607:Stents; D016896:Treatment Outcome
chemical_list: D004279:DNA, Viral
keywords: Coronary stent; Parvovirus B19; in-stent restenosis; target lesion revascularization