title: Higher immunoglobulin G antibody levels against cytomegalovirus are associated with incident ischemic heart disease in the population-based EPIC-Norfolk cohort.
abstract: BACKGROUND
  Cytomegalovirus (CMV) is associated with ischemic heart disease (IHD) among organ transplant recipients. The relationship between the levels of antibody for CMV with IHD in immunocompetent individuals is uncertain.
  
  
  METHODS
  We measured baseline CMV immunoglobulin G (IgG) levels in 12,574 participants without IHD from the population-based EPIC-Norfolk cohort, aged 40-70 years old at recruitment in 1993-1997. Underlying causes of death or hospitalization until 31 March 2008 were abstracted from death certificates and a database of hospital admissions, respectively.
  
  
  RESULTS
  Of the participants, 58% were seropositive for CMV. After a mean follow-up of 12 years (standard deviation, 2.2 years), 1356 first-time IHD events occurred. After adjustment for classic IHD risk factors, belonging to the highest antibody group was associated with an increased risk of incident IHD, compared with seronegativity (hazard ratio, 1.22; 95% confidence interval, 1.05-1.42). After additional adjustment for measures of social class, inflammation, and possible confounders, this association was unchanged (hazard ratio, 1.21; 95% confidence interval, 1.04-11.41).
  
  
  CONCLUSIONS
  This is the first population study to show that CMV IgG antibody levels are related to incident IHD compared to seronegativity. Studies correlating CMV antibody levels with direct measurements of active infection will be necessary.
authors.affiliation: Medical Research Council Epidemiology Unit, Institute of Metabolic Science, Addenbrooke's Hospital, Cambridge CB2 0QQ, United Kingdom. eg318@cam.ac.uk
authors.forename: Effrossyni
authors.initials: E
authors.lastname: Gkrania-Klotsas
authors.forename: Claudia
authors.initials: C
authors.lastname: Langenberg
authors.forename: Stephen J
authors.initials: SJ
authors.lastname: Sharp
authors.forename: Robert
authors.initials: R
authors.lastname: Luben
authors.forename: Kay-Tee
authors.initials: KT
authors.lastname: Khaw
authors.forename: Nicholas J
authors.initials: NJ
authors.lastname: Wareham
mesh_terms: D000328:Adult; D000368:Aged; D000914:Antibodies, Viral / Q000097:blood*; D003587:Cytomegalovirus / Q000276:immunology*; D003586:Cytomegalovirus Infections / Q000150:complications / Q000453:epidemiology*; D005260:Female; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood*; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000150:complications / Q000453:epidemiology*
chemical_list: D000914:Antibodies, Viral; D007074:Immunoglobulin G