[Direct evidence of cytomegalovirus in coronary atheromas of patients with advance coronary heart artery disease].
OBJECTIVE
Experimental and clinical data support an infectious cause of atherosclerosis and thereby coronary artery disease. This study was intended to assess the prevalence and possible clinical associations of the presence of cytomegalovirus DNA within coronary samples from patients undergoing coronary artery bypass grafting.


METHODS
A coronary thrombendatherectomy was performed in 53 patients with advanced coronary artery disease. Two samples of each atheroma were used for further analysis and pathogen detection.


RESULTS
In 30% of patients with advanced coronary artery disease cytomegalovirus DNA was detected in coronary samples as assessed by highly sensitive PCR methods. The occurrence of the virus within the vessels was characterized by an inhomogeneous distribution pattern.


CONCLUSIONS
Due to an increased proportion of restenotic lesions and a higher degree of calcification in cytomegalovirus-positive lesions, a causative association between the virus presence and mechanisms of restenosis post angioplasty is further supported. Antiviral pharmacological interventions to prevent restenosis in high-risk patients, however, seem not to be justified by the data currently available.
Radke
P W
PW
Medizinische Klinik I, RWTH Universitätsklinik Aachen. p.radke@ic.ac.uk
Merkelbach-Bruse
S
S
Dörge
H
H
Naami
A
A
Vogel
G
G
Messmer
B J
BJ
Handt
S
S
Hanrath
P
P
D000368:Aged; D017225:Atherectomy, Coronary; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000473:pathology / Q000601:surgery / Q000821:virology*; D003331:Coronary Vessels / Q000473:pathology / Q000821:virology*; D003587:Cytomegalovirus / Q000302:isolation & purification*; D003586:Cytomegalovirus Infections / Q000150:complications* / Q000453:epidemiology; D005858:Germany / Q000453:epidemiology; D006083:Graft Occlusion, Vascular; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012307:Risk Factors; D012720:Severity of Illness Index