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CMV seroprevalence and coronary CMV-DNA detection in immunocompetent patients with heart diseases

Valeria Cento1, Luna Colagrossi2, Irene Bossi3

  • 1Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy - valeria.cento@unimi.it.

Minerva Medica
|October 18, 2022
PubMed

Insights

Cytomegalovirus (CMV) reactivation may trigger acute coronary syndromes (ACS). CMV-DNAemia was detected in coronary circulation of ACS patients, particularly those without cardiovascular risk factors, suggesting a potential link.

Area of Science:

  • Cardiology
  • Virology
  • Immunology

Background:

  • Acute coronary syndromes (ACS) represent a significant global health burden.
  • Cytomegalovirus (CMV) reactivation is a potential, yet unproven, trigger for cardiovascular events.
  • Understanding the role of CMV in ACS pathogenesis is crucial for developing novel therapeutic strategies.

Purpose of the Study:

  • To investigate the potential role of coronary and systemic cytomegalovirus (CMV) reactivation as a trigger for acute coronary syndromes (ACS).
  • To establish a proof-of-concept for CMV involvement in the pathophysiology of ACS.
  • To compare CMV prevalence and DNAemia in ACS patients versus non-ACS controls.

Main Methods:

  • Prospective enrollment of 193 patients undergoing coronary angiography for ACS (n=136) or non-ACS reasons (n=57).
  • Quantification of CMV-DNAemia, CMV-IgG/IgM, and CMV-IgG avidity in matched coronary and peripheral blood samples using RT-PCR and ELISA.
  • Inclusion of 17 healthy subjects as controls for CMV seroprevalence comparison.

Main Results:

  • High CMV-IgG seroprevalence (91.7%) observed in patients, significantly higher than controls (52.9%).
  • Low-level CMV-DNAemia detected in 22.6% of patients, with coronary CMV-DNAemia more frequent in acute ACS cases lacking cardiovascular risk factors (40.0%) compared to chronic cases (10.9%) or acute cases with risk factors (14.3%).
  • No evidence of acute CMV infection; findings support a long history of CMV infection.

Conclusions:

  • High CMV seroprevalence in patients with heart disease underscores the virus's widespread presence.
  • CMV-DNAemia, though uncommon, is present in coronary circulation during ACS, particularly in older individuals and those without traditional cardiovascular risk factors.
  • These findings highlight potential avenues for novel interventions targeting CMV in ACS management.
Abstract

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