Key result
Prior CMV infection is linked to ~3% higher 30-day major events after coronary stenting.
Why the study?
Cytomegalovirus infection may increase the procoagulant properties of coronary artery plaques and thereby affect the risk of coronary thrombotic events after stent placement.
Does previous CMV infection increase the risk of early coronary thrombotic events in patients undergoing coronary stent placement?
Cohort (n=551)
Does previous CMV infection increase the risk of early coronary thrombotic events in patients undergoing coronary stent placement?
Previous CMV infection is significantly associated with an increased risk of early coronary thrombotic events following coronary stent placement.
Answers are grounded in this paper and cite their sources.
Positive CMV serology was associated with early thrombotic events after stenting; leaves open whether serostatus should inform periprocedural risk stratification or trials.
BACKGROUND: Cytomegalovirus (CMV) infection induces upregulation of tissue factor and loss of anticoagulants, including thrombomodulin, prostacyclin, and tissue plasminogen activator. CMV infection may thereby increase the procoagulant properties of coronary artery plaques. This prospective study investigated the effect of previous CMV infection on the early hazard of coronary stent placement. METHODS AND RESULTS: In 551 consecutive patients with successful coronary stent placement, we determined CMV IgG titers. The end point was the composite rate of death, nonfatal Q-wave myocardial infarction, and urgent reintervention during 30-day follow-up. The study population represented the entire spectrum of coronary stenting; an acute coronary syndrome was present in 50% of the patients. A positive CMV IgG titer (>/=1/230) was found in 340 patients (62%). Of these, 10 reached the end point during 30-day follow-up (2 deaths, 4 infarctions, 4 urgent reinterventions). In the group with negative CMV titer, thrombotic events did not occur (P=0.014 versus group with positive CMV titers). After correction for pertinent covariables, a significant relation between positive CMV titer and the 30-day end point prevailed (P<0.001). CONCLUSIONS: Previous CMV infection may increase the risk of coronary thrombotic events after stent placement.
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Neumann et al. (2000) conducted a cohort in Coronary stent placement (n=551). Previous cytomegalovirus (CMV) infection vs. Negative CMV titer was evaluated on Composite rate of death, nonfatal Q-wave myocardial infarction, and urgent reintervention during 30-day follow-up (p=<0.001). Previous cytomegalovirus infection was associated with a higher 30-day rate of death, MI, or urgent reintervention after coronary stenting compared to negative titers (2.9% vs 0%, P<0.001).
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