Cytomegalovirus Infection and Coronary Artery Disease in Liver Transplant Recipients: Nationwide Study Using Protocolised Cardiac Computed Tomography

OBJECTIVES;: Liver transplant recipients have a high burden of coronary artery disease (CAD). Post-transplant cytomegalovirus (CMV) infection is common and is associated with inflammation, possibly promoting atherosclerosis. We investigated if CMV infection is associated with CAD in liver transplant recipients. METHODS: In the Danish Comorbidity in Liver Transplant Recipients (DACOLT) Study (ClinicalTrials.gov: NCT04777032), adult liver transplant recipients underwent research cardiac computed tomography with assessment of CAD and systematic screening for CMV DNAemia. We assessed if prior CMV DNAemia and pre-transplant CMV serostatus were associated with CAD. RESULTS: We included 278 liver transplant recipients, of whom 44% had any calcified plaque (coronary artery calcium score CACS ≥1), and 29% had prior CMV DNAemia. The distribution of CACS (P = 0.514) and CAD severity (P = 0.198) did not differ between participants with and without prior CMV DNAemia. Prior CMV DNAemia and positive CMV serostatus were not associated with any calcified plaque (aOR 0.72 95% CI: 0.36-1.46 and 1.04 0.55-1.98, respectively) or any measures of CAD after adjustment for traditional cardiovascular risk factors and time since transplantation. CONCLUSIONS: We found no association between prior CMV infection and CAD in liver transplant recipients, indicating a limited role on post-liver transplantation CAD.