It has been shown that cytomegalovirus (CMV) is present in coronary atherosclerotic plaques, but the clinical relevance of this presence remains to be elucidated. In this study we sought to examine CMV infection in atherosclerosis patients defined by different methods and to identify the clinical significance of CMV replication in the atherosclerotic plaques. The study included 105 consecutive patients who were admitted to our department and underwent coronary artery bypass grafting (CABG) surgical interventions. Coronary atherosclerotic specimens as well as 53 specimens from the mamillary artery of these same patients were analyzed. Enzyme-linked immunosorbent assay (ELISA) and polymerase chain reaction (PCR) methods were used for evaluations. The CMV PCR test result was positive for 28 (26.7%) of patients with coronary artery atherosclerosis. After adjusting for other risk factors, coronary artery disease patients with a history of acute coronary syndrome were more likely to be positive for CMV PCR test (P = 0.027; odds ratio: 4.2; 95% CI: 1.18-15.0). They were also more likely to have a positive family history for cardiovascular diseases (CVD). This study confirms previous evidence about the replication of CMV virus in the atherosclerotic plaques of coronary arteries and brings clinical significance to this observation by showing a higher prevalence of acute coronary syndromes in those patients with CMV-infected plaques. Our study also suggests a familial vulnerability to CMV replication in the coronary artery walls.
In der chirurgischen Abteilung der Schloβpark-Klinik Berlin wurden zwischen Anfang 1984 und Ende 1988 202 Magenoperationen bei Ulkuskrankheit und Karzinomen durchgeführt. In einer Nachuntersuchung konnten 67 Patienten gastroskopiert werden. Von 11 Patienten nach selektiv proximaler Vagotomie waren 9 Helicobacter pyloripositiv (82%), von 12 Patienten nach Gastraler Vagotomie plus Antrektomie 6 (50%), von 22 Patienten nach Billroth II 12 (45%), von 6 Patienten nach Billroth I 3 (50%). 14 Patienten nach Teilresektion wegen Karzinom waren 7 HP-positiv (50%). Ein Zusammenhang zwischen postoperativer Befindlichkeit nach Visick und einer HP-Prävalenz beim jeweiligen OP-Verfahren fand sich nicht. Trat ein Rezidivulcus auf, so schienen Raucher zu überwiegen. Bei HP-Nachweis postoperativ vor oder nach 3 Jahren scheint kein Prävalenz-Unterschied zu bestehen. Bei HP-Positivität überwiegt die chro-nisch-aktive Gastritis die chronische Gastritis. Weitere prospektive Studien zur Rolle von HP im operierten Magen sind erforderlich.
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