title: Absence of Bacteria on Coronary Angioplasty Balloons from Unselected Patients: Results with Use of a High Sensitivity Polymerase Chain Reaction Assay.
abstract: Periodontitis is a chronic, bacterially-induced inflammatory disease of the tooth-supporting tissues, which may result in transient bacteremia and a systemic inflammatory response. Periodontitis is associated with coronary artery disease independently of established cardiovascular risk factors, and translocation of bacteria from the oral cavity to the coronary arteries may play a role in the development of coronary artery disease. Very few studies have used angioplasty balloons for in vivo sampling from diseased coronary arteries, and with varying results. Therefore, the aim of this study was to assess if bacterial DNA from primarily oral bacteria could be detected on coronary angioplasty balloons by use of an optimized sampling process combined with an internally validated sensitive polymerase chain reaction (PCR) assay. Coronary angioplasty balloons and control samples from a total of 45 unselected patients with stable angina, unstable angina/non-ST elevation myocardial infarction, and ST-elevation myocardial infarction (n = 15 in each group) were collected and analyzed using a PCR assay with high sensitivity and specificity for 16S rRNA genes of the oral microbiome. Despite elimination of extraction and purification steps, and demonstration of sensitivity levels of 25-125 colony forming units (CFU), we did not detect bacterial DNA from any of the coronary angioplasty balloons. A subsequent questionnaire indicated that the prevalence of periodontitis in the study cohort was at least 39.5%. Although coronary angioplasty balloons are unlikely to be useful for detection of bacteria with current PCR techniques in unselected patients with coronary artery disease, more studies are warranted to determine the extent to which bacteria contribute to atherosclerosis and its clinical manifestations and whether the presence of bacteria in the arteries is a transient phenomenon.
authors.affiliation: Department of Cardiology, Gentofte University Hospital, Hellerup, Denmark.|Costerton Biofilm Center, Department of Immunology and Microbiology, Faculty of Health and Medical Sciences, Copenhagen University, Copenhagen, Denmark.
authors.forename: Gorm Mørk
authors.initials: GM
authors.lastname: Hansen
authors.affiliation: Costerton Biofilm Center, Department of Immunology and Microbiology, Faculty of Health and Medical Sciences, Copenhagen University, Copenhagen, Denmark.
authors.forename: Martin
authors.initials: M
authors.lastname: Nilsson
authors.affiliation: Institute for Inflammation Research, Department of Infectious Diseases and Rheumatology, Rigshospitalet, Copenhagen, Denmark.|Section of Periodontology, Department of Odontology, Faculty of Health and Medical Sciences, Copenhagen University, Copenhagen, Denmark.
authors.forename: Claus Henrik
authors.initials: CH
authors.lastname: Nielsen
authors.affiliation: Section of Periodontology, Department of Odontology, Faculty of Health and Medical Sciences, Copenhagen University, Copenhagen, Denmark.
authors.forename: Palle
authors.initials: P
authors.lastname: Holmstrup
authors.affiliation: Department of Cardiology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.
authors.forename: Steffen
authors.initials: S
authors.lastname: Helqvist
authors.affiliation: Costerton Biofilm Center, Department of Immunology and Microbiology, Faculty of Health and Medical Sciences, Copenhagen University, Copenhagen, Denmark.
authors.forename: Tim
authors.initials: T
authors.lastname: Tolker-Nielsen
authors.affiliation: Costerton Biofilm Center, Department of Immunology and Microbiology, Faculty of Health and Medical Sciences, Copenhagen University, Copenhagen, Denmark.|Singapore Center on Environmental Life Sciences Engineering (SCELSE), Nanyang Technological University, Singapore.
authors.forename: Michael
authors.initials: M
authors.lastname: Givskov
authors.affiliation: Department of Cardiology, Gentofte University Hospital, Hellerup, Denmark.
authors.forename: Peter Riis
authors.initials: PR
authors.lastname: Hansen
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D060050:Angina, Stable / Q000601:surgery; D000789:Angina, Unstable / Q000601:surgery; D015906:Angioplasty, Balloon, Coronary / Q000295:instrumentation*; D001419:Bacteria / Q000235:genetics*; D004269:DNA, Bacterial / Q000235:genetics*; D004866:Equipment Contamination; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000601:surgery; D016133:Polymerase Chain Reaction / Q000379:methods*; D018746:Systemic Inflammatory Response Syndrome / Q000209:etiology / Q000382:microbiology
chemical_list: D004269:DNA, Bacterial