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Cytomegalovirus ‐ Productive Infection Is Associated With Acute Coronary Syndrome

View Article: PubMed Central - PubMed

ABSTRACT

Background: Although 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 results: Using 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.

Conclusions: Of 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.

No MeSH data available.


Related in: MedlinePlus

Receiver operating characteristic (ROC) curve for the cytomegalovirus (CMV) DNA load in patients with acute coronary syndrome compared with patients with stable coronary artery disease and healthy controls. The area under the ROC curve was 0.662 (95% CI 0.56–0.77, P=0.004). With the threshold of 142 copies of CMV DNA per microliter of plasma, specificity was 64.9% and sensitivity was 64.6%.
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jah31695-fig-0005: Receiver operating characteristic (ROC) curve for the cytomegalovirus (CMV) DNA load in patients with acute coronary syndrome compared with patients with stable coronary artery disease and healthy controls. The area under the ROC curve was 0.662 (95% CI 0.56–0.77, P=0.004). With the threshold of 142 copies of CMV DNA per microliter of plasma, specificity was 64.9% and sensitivity was 64.6%.

Mentions: To determine the threshold level of viral load in plasma for the patients with acute coronary events and with all CAD types, we performed a receiver operating characteristic analysis. The receiver operating characteristic curves were statistically significant in both cases (Figures 5 and 6). We defined a threshold level giving equal numbers of false‐negative and false‐positive results: 142 CMV DNA copies for ACS patients and 114 CMV DNA copies for ACS and SCAD patients combined. The area under the curve, however, was larger in the first case than in the second, and the sum of false‐negative and false‐positive results was lower for the threshold of 142. Based on this analysis, we determined that patients with ACS with high probability will have a CMV load of >142 DNA copies per microliter of plasma.


Cytomegalovirus ‐ Productive Infection Is Associated With Acute Coronary Syndrome
Receiver operating characteristic (ROC) curve for the cytomegalovirus (CMV) DNA load in patients with acute coronary syndrome compared with patients with stable coronary artery disease and healthy controls. The area under the ROC curve was 0.662 (95% CI 0.56–0.77, P=0.004). With the threshold of 142 copies of CMV DNA per microliter of plasma, specificity was 64.9% and sensitivity was 64.6%.
© Copyright Policy - creativeCommonsBy-nc
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC5015295&req=5

jah31695-fig-0005: Receiver operating characteristic (ROC) curve for the cytomegalovirus (CMV) DNA load in patients with acute coronary syndrome compared with patients with stable coronary artery disease and healthy controls. The area under the ROC curve was 0.662 (95% CI 0.56–0.77, P=0.004). With the threshold of 142 copies of CMV DNA per microliter of plasma, specificity was 64.9% and sensitivity was 64.6%.
Mentions: To determine the threshold level of viral load in plasma for the patients with acute coronary events and with all CAD types, we performed a receiver operating characteristic analysis. The receiver operating characteristic curves were statistically significant in both cases (Figures 5 and 6). We defined a threshold level giving equal numbers of false‐negative and false‐positive results: 142 CMV DNA copies for ACS patients and 114 CMV DNA copies for ACS and SCAD patients combined. The area under the curve, however, was larger in the first case than in the second, and the sum of false‐negative and false‐positive results was lower for the threshold of 142. Based on this analysis, we determined that patients with ACS with high probability will have a CMV load of >142 DNA copies per microliter of plasma.

View Article: PubMed Central - PubMed

ABSTRACT

Background: Although 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 results: Using 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.

Conclusions: Of 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.

No MeSH data available.


Related in: MedlinePlus