High anti-cytomegalovirus (CMV) IgG antibody titer is associated with coronary artery disease and may predict post-coronary balloon angioplasty restenosis

Recent studies have demonstrated that cytomegalovirus (CMV) DNA was found in atherosclerotic coronary arteries in restenotic lesions, and prior infection with CMV could be a strong independent risk factor for restenosis after coronary atherectomy, We studied the correlation between anti-CMV antibody titer and coronary artery disease, Sixty-five patients (50 men and 15 women) with coronary artery disease were enrolled prospectively, All had symptomatic coronary artery disease with an angiographic documentation of a de novo single coronary lesion, All underwent balloon coronary angioplasty and were followed for 12 months with a thallium perfusion scan 3 months after angioplasty, Patients who had recurrent chest pain and/or a positive thallium scan had another coronary angiography, Blood samples were taken before angiography and 1 and 3 months later, Patients with high anti-CMV titer greater than or equal to 1:800 had a higher prevalence of coronary artery disease (p <0.001) than seropositive patients with a lower antibody titer (less than or equal to):400); patients with high antibody titer (greater than or equal to 1:800) had a higher restenosis rate than seropositive patients with a low antibody titer (less than or equal to 1:400) (p <0.05), High antibody titers against CMV (IgG) may be a strong marker for coronary artery disease, and might predict post-coronary angioplasty restenosis. These findings support the infectious theory of atherosclerosis (especially with prior CMV infection), and also suggest that a chronic immunologic response has a role in atherosclerosis and restenosis. (C) 1998 by Excerpta Medica, Inc.