High Anti-Cytomegalovirus (CMV) IgG Antibody Titer is Associated With Coronary Artery Disease and May Predict Post-Coronary Balloon Angioplasty Restenosis

Blum, Arnon; Giladi, Michael; Weinberg, Mark; Kaplan, Giora; Pasternack, Hanoch; Laniado, Shlomo; Miller, Hylton

doi:10.1016/s0002-9149(98)00019-8

Cited by 119 publications

(88 citation statements)

References 17 publications

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“…13 It has been demonstrated that patients with atherosclerosis had higher antibody titer against CMV 14 and that one-third of the atherosclerotic lesions obtained by coronary atherectomy contained CMV DNA sequences. 4 Smooth muscle cells that were grown from such lesions expressed IE84 (one of the immediate early proteins of the virus that binds and inhibits p53). 4 These effects may enhance the proliferation of smooth muscle cells or inhibit apoptosis, either of which may contribute to accelerated atherosclerosis.…”

Section: The Infectious Theorymentioning

confidence: 99%

“…4 Smooth muscle cells that were grown from such lesions expressed IE84 (one of the immediate early proteins of the virus that binds and inhibits p53). 4 These effects may enhance the proliferation of smooth muscle cells or inhibit apoptosis, either of which may contribute to accelerated atherosclerosis. Prior infection with CMV has been suggested as a strong independent risk factor for restenosis after coronary atherectomy, 15 and there is a graded relation between the odds of intimal-medial thickening and levels of CMV antibodies that remained significant after adjustment for the main cardiovascular risk factors.…”

Section: The Infectious Theorymentioning

confidence: 99%

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Viral load of the human immunodeficiency virus could be an independent risk factor for endothelial dysfunction

et al. 2005

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SummaryBackground: Recent reports of myocardial infarction in young persons infected with human immunodeficiency virus (HIV) who are receiving protease inhibitor therapy have raised concerns about premature coronary artery disease in this population. However, endothelial dysfunction, hypercoagulability, hypertriglyceridemia, and abnormal coronary artery pathology have been observed in association with HIV infection prior to the availability of protease inhibitor therapy.Hypothesis: The study was undertaken to determine the association between endothelial function, viral load, CD4+ count, and other well-established risk factors for atherosclerosis.Methods: This prospective, case-controlled study compared viral (HIV) load and the CD4+ T-lymphocyte count and endothelial function in 24 HIV-positive carriers. Brachial artery diameter, HIV viral load, and CD4 count were measured.Results: We found that viral load correlated inversely with endothelial function; the higher the viral load, the worse the endothelial dysfunction (p < 0.005).Conclusion: High viral load appears to be associated with endothelial dysfunction in patients with HIV. This preliminary observation supports the infectious theory that viruses may play an important role in the pathogenesis of atherosclerosis.

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Section: The Infectious Theorymentioning

confidence: 99%

Section: The Infectious Theorymentioning

confidence: 99%

Viral load of the human immunodeficiency virus could be an independent risk factor for endothelial dysfunction

et al. 2005

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“…Cytomegalovirus (CMV) infection is also considered to increase the risk of development of CAD, [19][20][21] including a risk of restenosis after balloon angioplasty, 22,23) which may occur through p53 suppression by cytomegalovirus, because the absence of p53 increases vascular neointima formation. 24) Although microorganisms such as Cpn and CMV are thought to be associated with chronic coronary artery disease, the role of these pathogens in the initiation of acute coronary syndromes (ACS) is less well defined.…”

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confidence: 99%

Presence and Severity of Chlamydia pneumoniae and Cytomegalovirus Infection in Coronary Plaques Are Associated With Acute Coronary Syndromes

et al. 2006

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SUMMARYAlthough an association between Chlamydia pneumoniae (Cpn) or Cytomegalovirus (CMV) infection and coronary atherosclerosis has been reported, such an association is less clear for acute coronary syndromes (ACS). The purpose of this study was to investigate the pathogenic roles of Cpn and CMV infection of coronary plaques in ACS. We divided 38 coronary plaque specimens obtained from 38 patients who underwent directional coronary atherectomy or thrombectomy into an ACS group (n = 21) and a non-ACS group (n = 17). Cpn and CMV in specimens were stained using immunohistochemical techniques and analyzed quantitatively. The detection rate for either Cpn-or CMV-positive cells in ACS patients was slightly higher compared with non-ACS patients. Detection rates for both Cpn-and CMV-positive cells were significantly higher in ACS patients than in non-ACS patients (P = 0.010). Furthermore, the density of Cpn-and CMV-positive cells in plaques was significantly higher in ACS patients than in non-ACS patients (P < 0.003). The results indicate that the presence and severity of Cpn and CMV infection in coronary plaques are greater in patients with ACS compared with non-ACS patients. We conclude that infection with Cpn and CMV in coronary plaques may be involved in the pathogenesis of ACS. (Int Heart J 2006; 47: 511-519)

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“…However, there are some studies that show no relationship between the two (Adler et al 1998;Blum et al 1998;Sorlie et al 2000).…”

Section: Human Cytomegalovirusmentioning

confidence: 99%

Homocysteine and Malondialdehyde as Predictors of Restenosis Following Percutaneous Coronary Intervention

et al. 2006

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Restenosis is one of the major adverse outcomes of Percutaneous CoronaryIntervention (PCI). Previous studies have shown conflicting reports for homocysteine as a predictor of restenosis following PCI. The conflicting reports may be due to oxidative factors (stimulation of polymorphonuclear leukocyte [PMNL]-induced reactive oxygen species generation, xanthine-xanthine oxidase, and arachidonic acid metabolism) other than homocysteine which could cause endothelial cell dysfunction leading to restenosis.Malondialdehyde (MDA), a lipid peroxidation product, is a marker for oxidative stress and is related to all oxidative factors. Therefore, it is possible that serum MDA may be a better predictor of restenosis than plasma homocysteine. The purpose of this study is to determine whether or not the pre-procedural serum MDA and plasma homocysteine levels are elevated in patients who develop restenosis post PCI.The study included fifty-one patients undergoing elective PCI who consented to participate in a protocol that was approved by the Ethics Committee of the University of Saskatchewan. Homocysteine and malondialdehyde were measured in the plasma and serum respectively. Blood samples were collected pre-procedural, 0 time, 8 hours, 24 hours, and 6 months post-procedure. Exercise tolerance tests were performed at two weeks, and six months post-procedure to determine if there was any evidence of restenosis.The results of the study showed that pre-procedural values of plasma homocysteine in the restenosis and non-restenosis groups were 10.37 ± 0.46 and 10.73 ± 0.49 respectively. These values were not significantly different (p=0.60) between the groups. The pre-procedural levels of plasma homocysteine were not significantly ii different (p=0.08) from the post-PCI values of those patients who did not develop restenosis at the 6-month time interval. However, the pre-procedural levels of plasma homocysteine were significantly different from the post-PCI values of those patients in the restenosis group at the 24hr (p=0.04) and 6-month (p=0.002) time intervals. In the restenosis group there was a significant increase (24%) after six months in the values of homocysteine from the pre-procedural levels. Thus, this indicates that restenosis is associated with higher post-PCI levels of homocysteine.The pre-procedural levels of serum MDA in the restenosis and non-restenosis groups were 0.124± 0.16 and 0.147± 0.02 respectively. There was no significant difference (p=0.60) between the two groups. There was also no significant difference The results suggest that pre-procedural levels of plasma homocysteine and serum MDA were not predictors of restenosis following PCI. However, the post-PCI sixmonth levels of both homocysteine and MDA are predictors of restenosis. Moreover, the post-PCI levels of MDA were better predictors of restenosis than the post-PCI levels of homocysteine because the increase in MDA levels were greater at six months than the rise in homocysteine levels at the same time interval.iii ACKNOWLEDGEMENTS

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High Anti-Cytomegalovirus (CMV) IgG Antibody Titer is Associated With Coronary Artery Disease and May Predict Post-Coronary Balloon Angioplasty Restenosis

Cited by 119 publications

References 17 publications

Viral load of the human immunodeficiency virus could be an independent risk factor for endothelial dysfunction

Viral load of the human immunodeficiency virus could be an independent risk factor for endothelial dysfunction

Presence and Severity of Chlamydia pneumoniae and Cytomegalovirus Infection in Coronary Plaques Are Associated With Acute Coronary Syndromes

Homocysteine and Malondialdehyde as Predictors of Restenosis Following Percutaneous Coronary Intervention

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