Previous cytomegalovirus infection and restenosis after aggressive angioplasty with provisional stenting.
The aim of this study was to determine the impact of previous with cytomegalovirus (CMV) on restenosis after aggressive angioplasty with provisional stenting.


METHODS
We prospectively studied 78 consecutive patients scheduled for 6-month follow-up coronary angiography as part of the SIPS study. Anti-CMV IgG and IgM antibodies were measured on admission.


RESULTS
Anti-CMV IgG positive and anti-CMV IgG negative patients had similar minimal lumen diameter (MLD) in the target vessel before (0.68 +/- 0.49 mm vs 0.71 +/- 0.52 mm, P = 0.84) and directly after the intervention (2.50 +/- 0.60 mm vs 2.57 +/- 0.52 mm, P = 0.58). After 6 months, however, the MLD was significantly smaller in CMV-positive as compared to CMV-negative patients (1.57 +/- 0.82 mm vs 2.00 +/- 0.83 mm, P < 0.03). Net lumen gain at 6 months was significantly lower in CMV-positive patients (0.89 +/- 0.79 mm vs 1.30 +/- 0.87 mm, P < 0.04) and the rate of clinically relevant restenosis was significantly higher (31% vs 7%, P < 0.02). In a multivariate logistic regression model, CMV seropositivity was an independent predictor of restenosis (odds ratio 5.7 (95% CI 1.2-30.3, P = 0.04).


CONCLUSIONS
Six months after aggressive coronary angioplasty with provisional stenting, patients with prior CMV infection had a smaller MLD and a higher restenosis rate. CMV seropositivity was a strong independent predictor of restenosis.
Mueller
Christian
C
Herz-Zentrum Bad Krozingen, Germany. chmueller@uhbs.ch
Hodgson
John McB
JM
Bestehorn
Hans-Peter
HP
Brutsche
Martin
M
Perruchoud
Andrè P
AP
Marsch
Stephan
S
Roskamm
Helmut
H
Buettner
Heinz J
HJ
D015906:Angioplasty, Balloon, Coronary; D023903:Coronary Restenosis / Q000209:etiology*; D023921:Coronary Stenosis / Q000628:therapy*; D003586:Cytomegalovirus Infections / Q000150:complications*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D015607:Stents