Cytomegalovirus infection in acute myocardial infarction. Is there a causative relationship?

BACKGROUND: Cytomegalovirus (CMV) infection has been suggested to play an important role in the pathogenesis of atherosclerosis. Whether CMV may be involved in the development of acute myocardial infarction (MI) has not yet been established. AIM: To asses the prevalence of active or latent CMV infection in patients with angina or acute MI. METHODS: The study group consisted of 158 subjects divided into three groups: group I - 70 patients (49 males, mean age 57.1+/-10.4 years) with acute MI, group II - 40 patients (21 males, mean age 59.1+/-7.9 years) with stable angina, and group III - 48 healthy controls (18 males, mean age 54.9+/-12.1 years). Anti-CMV IgM and IgG antibody titre in blood serum was measured in all subjects. In those in whom anti-CMV antibodies were present, quantitative polimerase chain reaction (Q-PCR) was performed in order to detect DNA of CMV in peripheral blood mono-nuclear cells (PBMC) and in serum. RESULTS: Anti-CMV IgM antibodies were not detected in any of the subjects. A positive result of anti-CMV IgG test was present in 60 (85.7%) patients from group I, 34 (85%) patients from group II, and 15 (31.5%) control subjects. The mean IgG antibody concentration was 72.2+/-13.6 aU/ml, 74.23+/-12.8 aU/ml and 19.57+/-3.56 aU/ml, respectively (p<0.001). In patients from group I, a significantly higher prevalence of serum DNA CMV was noted than in the remaining groups. CONCLUSIONS: Patients with symptomatic coronary artery disease have a significantly higher anti-CMV antibody titre than healthy subjects. The active form of infection is significantly more prevalent in patients with acute MI than in patients with stable angina.