title: Cytomegalovirus exposure and cardiovascular disease in kidney transplant recipients.
abstract: Some data suggest that cytomegalovirus (CMV) may be involved in atherogenesis. However, there are few data suggesting that CMV may contribute to posttransplantation atherosclerosis. We studied a cohort of 570 consecutive renal transplant recipients. The impact of CMV on atherosclerotic events was analyzed with respect to other known main cardiovascular risk factors. The mean follow-up duration (± SD) was 87 ± 31 months. A total of 357 patients were considered to be CMV exposed, and 213 were considered to be CMV naive. Cox regression analysis revealed that CMV exposure (hazard ratio [HR], 1.80 [95% confidence interval {CI}, 1.06-3.05]; P = .030) was an independent risk factor for atherosclerotic events. A total of 213 patients remained CMV negative during follow-up, 225 CMV-positive patients had no replication after transplantation, and 132 CMV-positive patients experienced CMV replication after transplantation. Atherosclerotic event rates were 8.5%, 13.3%, and 18.2%, respectively (P = .034). Cox regression analysis revealed that patients with posttransplantation CMV replication had an increased risk of atherosclerotic events (HR, 2.06 [95% CI, 1.03-4.15]; P = .042) and death (HR, 1.76 [95% CI, 1.08-2.89]; P = .024). There was also a trend toward an increased risk of atherosclerotic events in CMV-positive patients without posttransplantation replication (HR, 1.62 [95% CI, .91-3.05]; P = .098). Both pretransplantation CMV exposure and posttransplantation CMV replication contribute to the increased risk of cardiovascular disease in transplant recipients.
authors: UMR1098, INSERM, Besançon, France. ccourivaud@chu-besancon.fr
authors: Cécile
authors: C
authors: Courivaud
authors: Jamal
authors: J
authors: Bamoulid
authors: Jean-Marc
authors: JM
authors: Chalopin
authors: Emilie
authors: E
authors: Gaiffe
authors: Pierre
authors: P
authors: Tiberghien
authors: Philippe
authors: P
authors: Saas
authors: Didier
authors: D
authors: Ducloux
mesh_terms: D000328:Adult; D002318:Cardiovascular Diseases / Q000453:epidemiology* / Q000209:etiology / Q000821:virology; D003587:Cytomegalovirus / Q000472:pathogenicity* / Q000502:physiology; D003586:Cytomegalovirus Infections / Q000150:complications / Q000453:epidemiology* / Q000821:virology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D016030:Kidney Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology* / Q000209:etiology / Q000821:virology; D016016:Proportional Hazards Models; D012307:Risk Factors; D015996:Survival Rate; D014779:Virus Replication