Cytomegalovirus in Plasma of Acute Coronary Syndrome Patients

Abstract

The relationship between acute coronary syndrome (ACS) and local and systemic inflammation, including accumulation of macrophages in atherosclerotic plaques and upregulation of blood cytokines (e.g., C-reactive protein (CRP)), has been known for more than 100 years. The atherosclerosis-associated inflammatory response has been traditionally considered as an immune system reaction to low-density lipoproteins. At the same time, some data have indicated a potential involvement of cytomegalovirus (CMV) in the activation and progression of atherosclerosis-associated inflammation, leading to ACS. However, these data have been tangential and mainly concerned the relationship between a coronary artery disease (CAD) prognosis and the anti-CMV antibody titer. We assumed that ACS might be associated with CMV reactivation and virus release into the bloodstream. The studys aim was to test this assumption through a comparison of the plasma CMV DNA level in patients with various CAD forms and in healthy subjects. To our knowledge, no similar research has been undertaken yet. A total of 150 subjects (97 CAD patients and 53 healthy subjects) were examined. Real-time polymerase chain reaction (RT-PCR) was used to determine the number of plasma CMV DNA copies. We demonstrated that the number of plasma CMV genome copies in ACS patients was significantly higher than that in healthy subjects (p = 0.01). The CMV genome copy number was correlated with the plasma CRP level (p = 0.002). These findings indicate a potential relationship between CMV activation and atherosclerosis exacerbation that, in turn, leads to the development of unstable angina and acute myocardial infarction. Monitoring of the CMV plasma level in CAD patients may be helpful in the development of new therapeutic approaches to coronary atherosclerosis treatment.

The Role of CMV Infection in Primary Lesions, Development and Clinical Expression of Atherosclerosis

“…Recent studies showed a higher viral load in STEMI patients compared to controls [21] and a direct relationship between T cells activation and the number of CMV-DNA copies inside the atherosclerotic plaques in patients with peripheral artery disease [22]. A higher number of CMV-DNA copies were detected in patients with preexistent cardiovascular risk factors and were associated to acute coronary syndrome, suggesting that CMV reactivation may lead to the progression of atherosclerotic lesions, for example, transforming stable angina into unstable angina or myocardial infarction [23]. CMV-DNA was found in aortic plaques, but not in normal artery samples obtained from candidates for coronary artery by-pass graft [24].…”

Novel coronavirus infection COVID-19: extrapulmonary manifestations

“…ОКС при COVID-19. Тромбоз коронарных артерий при COVID-19 может развиваться по двум основным механизмам: во-первых, как проявление коагулопатии, характерной для данного заболевания [17,19,25,26]; во-вторых, вследствие дестабилизации коронарного атеросклероза в ответ на вирусную инфекцию и системное воспаление [27][28][29][30]. По имеющимся данным, ОКС имеет определенный вес в структуре смертности среди госпитализированных пациентов с COVID-19.…”

Cytomegalovirus Infection and Endothelial Function in Patients With Acute Myocardial Infarction

“…Сведения о числе копий ДНК ЦМВ в настоящей работе отличались от результатов работы Е. А. Никитской и соавт. [68], вероятно, в связи с измененной в настоящей работе методикой экстракции вирусной ДНК с использованием высокочувствительного метода UltraSense Virus kit («Qiagen», Германия). Нами также выявлена ОСТРЫЙ КОРОНАРНЫЙ СИНДРОМ § достоверная разница по числу копий ДНК ЦМВ в зависимости от наличия АГ и возраста обследуемых.…”