<i>Chlamydia pneumoniae</i>
            , Herpes Simplex Virus Type 1, and Cytomegalovirus and Incident Myocardial Infarction and Coronary Heart Disease Death in Older Adults

Siscovick, David S.; Schwartz, Stephen M.; Corey, Lawrence; Grayston, J. T.; Ashley, Rhoda; Wang, S P; Psaty, Bruce M.; Tracy, Russell P.; Kuller, Lewis H.; Kronmal, Richard A.

doi:10.1161/01.cir.102.19.2335

Cited by 128 publications

(87 citation statements)

References 41 publications

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“…13 In a case-control study of 213 elderly patients with a known myocardial infarction or coronary artery disease, CMV seropositivity was also not associated with mortality during a 2-year average follow-up period. 12 In this study, however, antibodies to herpes simplex type 1 and high titer antibodies to Chlamydia pneumoniae were independent risk factors for death.…”

Section: Articlecontrasting

confidence: 57%

“…9,10 Other studies have not confirmed an association between CMV infections and/or high antibody titers and coronary artery disease. [11][12][13] Although there is currently no licensed CMV vaccine, CMV is a vaccine preventable infection. 14 Current vaccine strategies contemplate immunizing women of child-bearing age and transplant recipients.…”

Section: Introductionmentioning

confidence: 99%

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Infection with Cytomegalovirus is not Associated with Premature Mortality

Adler

Best

Marshall

et al. 2011

Infectious Disease Reports

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Over 90% of the world's population acquires a cytomegalovirus (CMV) infection. This infection, although asymptomatic or self-limiting, is a major burden to the immune system. For this reason, and because CMV immunization is possible, determining whether CMV can cause reduced longevity, particularly among those with coronary artery disease, is important and previous reports have been conflicting. Thus our objective was to assess the association between CMV infection as defined serologically and antibody levels against CMV and longterm survival (18 years). We completed a prospective observational cohort study of 915 consecutive patients (mean age 58 years) undergoing coronary angiography. CMV immunoglobulin levels were measured at baseline using either a whole cell CMV antigen or a purified protein antigen (gB). After adjustment for potentially confounding variables (age, race, gender, body mass index, the presence or absence of coronary artery disease, the number of diseased vessels, diabetes, renal disease, hypertension, dialysis, congestive heart failure, and the maximum percent reduction in luminal diameter), Cox's proportional hazards models showed no association between CMV seropositivity or levels of antibodies against CMV by either assay and longevity for both patients with or without coronary artery disease (CAD) nor for those under or over 70 years of age at baseline. Our observations suggest that universal immunization against CMV may not improve longevity.

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Section: Articlecontrasting

confidence: 57%

Section: Introductionmentioning

confidence: 99%

Infection with Cytomegalovirus is not Associated with Premature Mortality

Adler

Best

Marshall

et al. 2011

Infectious Disease Reports

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“…Seropositivity for CMV (or the level of CMV immunoglobulin G antibodies) has been reported to be associated with cardiovascular disease 30, 31. Furthermore, positive serology for HHV‐1 has been found to be associated with a higher risk of myocardial infarction or cardiovascular death 32, 33. In autopsies of aortic tissues that were identified histologically as atherosclerotic, DNA of HHV‐1, HHV‐4, and CMV were present more frequently than in nonatherosclerotic tissues 34, 35.…”

Section: Discussionmentioning

confidence: 99%

Cytomegalovirus‐Productive Infection Is Associated With Acute Coronary Syndrome

Nikitskaya

Lebedeva

Ivanova

et al. 2016

JAHA

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BackgroundAlthough an association between human herpesvirus (HHV) infection and atherosclerosis has been suggested, the data supporting such an association are controversial and, in most cases, are based on serological evidence or on the presence of cell‐associated HHV DNA, which do not report about actual viral replication. We quantified the DNA of all 8 types of HHVs in plasma, in which their presence is evidence of viral replication.Methods and ResultsUsing quantitative real‐time polymerase chain reaction, we evaluated the presence of HHV DNA in blood samples obtained at the time of hospitalization from 71 patients with acute coronary syndrome, 26 patients with stable coronary artery disease, and 53 healthy volunteers and in atherosclerotic plaques of 22 patients with peripheral artery disease who underwent endarterectomy. HHV‐5 (cytomegalovirus [CMV]) was the only HHV with a level that was higher in acute coronary syndrome patients than in the control group and that correlated with the level of high‐sensitivity C‐reactive protein. The numbers of effector memory T cells positively correlated with the numbers of CMV genome copies in carotid arteries plaques, whereas the numbers of central memory T cells negatively correlated with CMV copy numbers.ConclusionsOf all HHV levels, only CMV was higher in patients with stable coronary artery disease and acute coronary syndrome than in the healthy group, and its load correlated with the level of high‐sensitivity C‐reactive protein. The level of CMV in atherosclerotic plaques correlated with the state of immunoactivation of lymphocytes in plaques, suggesting that the reactivation of CMV may contribute to the immune activation associated with the progression of atherosclerosis.

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“…As such, the study provides a crucial link by which pathogens may contribute to atherogenesis. 25,34,35 …”

Section: Discussionmentioning

confidence: 99%

Predisposition to Atherosclerosis by Infections

et al. 2002

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Background — Several microorganisms have been implicated in the pathogenesis of atherosclerosis. We hypothesized that infections may predispose to atherosclerosis by inflicting endothelial injury. Methods and Results — Of 375 patients undergoing coronary angiography, 218 had assessment of endothelial function using intracoronary acetylcholine (ACH) and of endothelium-independent function with sodium nitroprusside and adenosine. Immunoglobulin-G antibody titers to cytomegalovirus, Chlamydia pneumoniae , Helicobacter pylori , hepatitis A virus, and herpes simplex virus-1 were measured. Pathogen burden was defined as the number of positive antibodies. Although positive serology to individual pathogens tended to be associated with increased incidence of coronary arteriosclerosis (CAD), the pathogen burden correlated with the presence of CAD, even after adjustment for risk factors (OR 1.3; 95% CI, 1.05 to 1.6, P =0.018). Moreover, the severity of CAD was independently associated with the pathogen burden ( P =0.001). Pathogen burden was an independent predictor of endothelial dysfunction, determined as the percent change in coronary vascular resistance in response to ACH ( P =0.009) but not the responses to sodium nitroprusside or adenosine. Pathogen burden was also an independent determinant of endothelial function in the subgroup with angiographically normal coronary arteries. Conclusions — The immunoglobulin-G antibody response to multiple pathogens (pathogen burden) is an independent risk factor for endothelial dysfunction and the presence and severity of CAD. Endothelial dysfunction provides the crucial link by which pathogens may contribute to atherogenesis.

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Chlamydia pneumoniae , Herpes Simplex Virus Type 1, and Cytomegalovirus and Incident Myocardial Infarction and Coronary Heart Disease Death in Older Adults

Cited by 128 publications

References 41 publications

Infection with Cytomegalovirus is not Associated with Premature Mortality

Infection with Cytomegalovirus is not Associated with Premature Mortality

Cytomegalovirus‐Productive Infection Is Associated With Acute Coronary Syndrome

Predisposition to Atherosclerosis by Infections

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