Role of cytomegalovirus sero-status in the development of secondary cardiovascular events in patients with coronary heart disease under special consideration of diabetes

Guech-Ongey, Mercy; Brenner, Hermann; Twardella, Dorothee; Hahmann, Harry; Rothenbacher, Dietrich

doi:10.1016/j.ijcard.2005.07.028

Cited by 15 publications

(8 citation statements)

References 20 publications

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“…We believe that the literature reviewed in this article explains to a large extent the striking epidemiological association reported between CMV infection and increased CV mortality ( 50 , 60 , 99 – 102 ). It is, in particular, the emerging, immediate and specific role of CD4 + CD28 − T cells in both acute and chronic vascular pathology that takes this association to a higher level.…”

Section: Discussionmentioning

confidence: 71%

Expansions of Cytotoxic CD4+CD28− T Cells Drive Excess Cardiovascular Mortality in Rheumatoid Arthritis and Other Chronic Inflammatory Conditions and Are Triggered by CMV Infection

et al. 2017

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A large proportion of cardiovascular (CV) pathology results from immune-mediated damage, including systemic inflammation and cellular proliferation, which cause a narrowing of the blood vessels. Expansions of cytotoxic CD4+ T cells characterized by loss of CD28 (“CD4+CD28− T cells” or “CD4+CD28null cells”) are closely associated with cardiovascular disease (CVD), in particular coronary artery damage. Direct involvement of these cells in damaging the vasculature has been demonstrated repeatedly. Moreover, CD4+CD28− T cells are significantly increased in rheumatoid arthritis (RA) and other autoimmune conditions. It is striking that expansions of this subset beyond 1–2% occur exclusively in CMV-infected people. CMV infection itself is known to increase the severity of autoimmune diseases, in particular RA and has also been linked to increased vascular pathology. A review of the recent literature on immunological changes in CVD, RA, and CMV infection provides strong evidence that expansions of cytotoxic CD4+CD28− T cells in RA and other chronic inflammatory conditions are limited to CMV-infected patients and driven by CMV infection. They are likely to be responsible for the excess CV mortality observed in these situations. The CD4+CD28− phenotype convincingly links CMV infection to CV mortality based on a direct cellular-pathological mechanism rather than epidemiological association.

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Section: Discussionmentioning

confidence: 71%

Expansions of Cytotoxic CD4+CD28− T Cells Drive Excess Cardiovascular Mortality in Rheumatoid Arthritis and Other Chronic Inflammatory Conditions and Are Triggered by CMV Infection

et al. 2017

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“…This observation deviates from the findings of other retrospective studies. 8 Further studies focusing on HCMV infection and subtypes of stroke are encouraged in the future to clarify this issue. Thirdly, there were no data for high-sensitivity C-reactive protein, interleukin, or cytokines, which might help us to explain the underlying inflammatory mechanisms for the association between HCMV infection and incident stroke.…”

Section: Discussionmentioning

confidence: 99%

“…8-12 Guech-Ongey et al 8 and Potena et al 9 reported a positive association between HCMV infection and cardiovascular disease (CVD), and indicated that HCMV infection is one of the main causes in cerebral infarction patients. In a recent case-control study, Huang et al demonstrated that HCMV seropositivity was higher in the stroke group than in controls (55.0% vs. 23.5%, P<0.05) and the presence of HCMV DNA increased the risk of stroke.…”

mentioning

confidence: 99%

Human Cytomegalovirus Increases the Risk of Future Hemorrhagic But Not Ischemic Stroke　– A Nested Case-Control Study –

Zheng

Sun

et al. 2016

Circ J

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Circulation Journal Official Journal of the Japanese Circulation Society http://www. j-circ.or.jp retrospective studies have reported an increased risk of stroke and coronary artery disease (CAD) in association with HCMV infection. 8-12 Guech-Ongey et al 8 and Potena et al 9 reported a positive association between HCMV infection and cardiovascular disease (CVD), and indicated that HCMV infection is one of the main causes in cerebral infarction patients. In a recent case-control study, Huang et al demonstrated that HCMV seropositivity was higher in the stroke group than in controls (55.0% vs. 23.5%, P<0.05) and the presence of HCMV DNA increased the risk of stroke. 12 However, there are also a few epidemiological studies that have found different results. 13,14 In a prospective study over a 12-year follow-up period, Ridker et al found that IgG antibodies directed against CMV do not appear to be a marker for increased risk of future stroke (hazard ratio: 0.72, 95% confidence interval (CI), 0.6-0.9). 13 In summary, the association between HCMV and risk of troke is the second commonest cause of death and the leading cause of adult disability worldwide. 1 Results from a large standardized case-control study (INTERSTROKE) indicate that traditional major risk factors for stroke include hypertension, current smoking, abdominal obesity, diet, and physical inactivity. 2 However, these risk factors cannot account for all of the global risk of all strokes. How to identify novel risk factors for stroke is still an urgent issue. 3 More recently, inflammation has been associated with an increased risk of cardiovascular events, including stroke. 4-6 Atherosclerosis is regarded as a chronic low-grade inflammation, initiated and deteriorated by a combination of classical risk factors and novel risk factors, such as viruses. Human cytomegalovirus (HCMV) belongs to the β-herpes virus subfamily, which after primary infection persists for the lifespan of the host. Background: The cause-and-effect relationship between human cytomegalovirus (HCMV) and stroke has not been widely elucidated. We aimed to determine if HCMV infection has an increased risk of future stroke in hypertensive patients in rural areas of China.

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“…CMV infection can be associated with thrombocytopenia, thrombotic thrombocytopenic purpura [50], and acute arterial and venous thromboembolism [51, 52]. …”

Section: Cytomegalovirusmentioning

confidence: 99%

Microbial Risk Factors of Cardiovascular and Cerebrovascular Diseases: Potential Therapeutical Options

Abbas

Guenther²,

Galantucci³

et al. 2008

TONEUJ

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Infection and inflammation may have a crucial role in the pathogenesis of atherosclerosis. This hypothesis is supported by an increasing number of reports on the interaction between chronic infection, inflammation, and atherogenesis. Assessment of serological and inflammatory markers of infection may be useful adjuncts in identifying those patients who are at a higher risk of developing vascular events, and in whom more aggressive treatments might be warranted.

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Role of cytomegalovirus sero-status in the development of secondary cardiovascular events in patients with coronary heart disease under special consideration of diabetes

Cited by 15 publications

References 20 publications

Expansions of Cytotoxic CD4+CD28− T Cells Drive Excess Cardiovascular Mortality in Rheumatoid Arthritis and Other Chronic Inflammatory Conditions and Are Triggered by CMV Infection

Expansions of Cytotoxic CD4+CD28− T Cells Drive Excess Cardiovascular Mortality in Rheumatoid Arthritis and Other Chronic Inflammatory Conditions and Are Triggered by CMV Infection

Human Cytomegalovirus Increases the Risk of Future Hemorrhagic But Not Ischemic Stroke　– A Nested Case-Control Study –

Microbial Risk Factors of Cardiovascular and Cerebrovascular Diseases: Potential Therapeutical Options

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Role of cytomegalovirus sero-status in the development of secondary cardiovascular events in patients with coronary heart disease under special consideration of diabetes

Cited by 15 publications

References 20 publications

Expansions of Cytotoxic CD4+CD28− T Cells Drive Excess Cardiovascular Mortality in Rheumatoid Arthritis and Other Chronic Inflammatory Conditions and Are Triggered by CMV Infection

Expansions of Cytotoxic CD4+CD28− T Cells Drive Excess Cardiovascular Mortality in Rheumatoid Arthritis and Other Chronic Inflammatory Conditions and Are Triggered by CMV Infection

Human Cytomegalovirus Increases the Risk of Future Hemorrhagic But Not Ischemic Stroke – A Nested Case-Control Study –

Microbial Risk Factors of Cardiovascular and Cerebrovascular Diseases: Potential Therapeutical Options

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Human Cytomegalovirus Increases the Risk of Future Hemorrhagic But Not Ischemic Stroke　– A Nested Case-Control Study –