Association of Cytomegalovirus Diseases with Newly Developed Myocardial Infarction and Congestive Heart Failure: Data from a National Population-based Cohort

Introduction Anti-cytomegalovirus (CMV) IgG seropositive and/or titer are associated with a higher risk of cardiovascular diseases (CVD). However, it is not clear whether CMV end-organ disease may have relation to development of CVD or chronic heart diseases. Material and methods In matched cohort study, National Health Insurance Database covering 50 million people was used to identify 667 patients with CMV diseases and aged ≥20 year-old between 2010 and 2014. 6,670 of control subjects without CMV diseases were matched by age, sex, type 2 diabetes mellitus (DM), hypertension, dyslipidemia, and cohort entry year. Data on CMV disease and heart disease events of myocardial infarction (MI), congestive heart failure (CHF), and atrial fibrillation (AF) were retrieved. Previous events before CMV disease or cohort entry were excluded until January 2006. Subjects were followed until December 2015 in subjects without events and until date of events in subjects with events. Results Multivariate regression model adjusted by age, sex, low-income status, type 2 DM, hypertension, dyslipidemia, solid organ transplantation, and hematopoietic stem cell transplantation showed a significantly higher incidence rate of MI (odds ratio [OR]: 2.1, 95% confidence intervals [CI]: 1.0-4.5) and CHF (OR: 3.8, 95% CI: 2.1-6.8) but not AF (OR: 1.9, 95% CI: 0.9-4.0) in patients with CMV disease. Age group of 40-64-year-old with CMV disease had the highest risk for new-onset CHF in this regression model (OR: 9.4, 95% CI: 4.12-21.44, P = 0.029). Conclusions Symptomatic CMV tissue-invasive diseases were associated with a higher risk of new-onset MI and CHF.