Guech-Ongey Mercy, Brenner Hermann, Twardella Dorothee, Hahmann Harry, Rothenbacher Dietrich
Department of Epidemiology, German Centre for Research on Ageing, University of Heidelberg, Bergheimer Str. 20 69115 Heidelberg, Germany.
Int J Cardiol. 2006 Jul 28;111(1):98-103. doi: 10.1016/j.ijcard.2005.07.028. Epub 2005 Oct 17.
We investigated prospectively the role of cytomegalovirus (CMV) sero-status in the development of secondary cardiovascular disease (CVD) events in patients with coronary heart disease (CHD) under special consideration of diabetes mellitus.
There have been suggestions of an association between cytomegalovirus infection sero-status and development of secondary cardiovascular events. Patients with diabetes might be at higher risk since they are relatively immunocompromised.
Patients aged 30-70 undergoing an in-patient rehabilitation program after acute manifestation of coronary heart disease between January 1999 and May 2000 were included in this analysis. CMV status at baseline was measured by serum immunoglobulin G antibodies. Secondary CVD events (myocardial infarction, stroke, and cardiovascular death) were recorded during a mean follow-up period of 33.5 months.
Among the 1033 subjects with measured IgG antibody for CMV, 56.5% were sero-positive to CMV at baseline. During follow-up, secondary CVD events occurred among 71 (6.9%) participants. Occurrence of a secondary CVD event was more common among sero-positive than among sero-negative patients (adjusted hazard ratio, HR, 1.31, 95% confidence interval (CI) 0.80-2.20), among patients with diabetes HR 2.00 (95% CI 1.20-3.25). The risk of secondary CVD events was strongly increased among patients with both a positive CMV sero-status and diabetes (adjusted HR 2.58, 95% CI 1.32-5.10) compared to CMV negative, non-diabetic patients, whereas either conditions alone was associated with a weak and non-significant increase in risk only.
Our results are consistent with a possible moderate increase in risk of secondary CVD events among patients with a positive CMV sero-status, and they indicate a strongly increased risk among CMV positive patients with diabetes.
我们前瞻性地研究了巨细胞病毒（CMV）血清学状态在冠心病（CHD）患者继发心血管疾病（CVD）事件发生中的作用，并特别考虑了糖尿病因素。
已有研究表明巨细胞病毒感染血清学状态与继发心血管事件的发生之间存在关联。糖尿病患者可能因免疫功能相对低下而面临更高风险。
纳入1999年1月至2000年5月间因冠心病急性发作而接受住院康复治疗的30至70岁患者进行分析。通过血清免疫球蛋白G抗体检测基线时的CMV状态。在平均33.5个月的随访期内记录继发CVD事件（心肌梗死、中风和心血管死亡）。
在1033名检测了CMV IgG抗体的受试者中，56.5%在基线时CMV血清学呈阳性。随访期间，71名（6.9%）参与者发生了继发CVD事件。继发CVD事件在血清学阳性患者中比血清学阴性患者更常见（调整后风险比，HR，1.31，95%置信区间（CI）0.80 - 2.20），在糖尿病患者中HR为2.00（95% CI 1.20 - 3.25）。与CMV阴性、非糖尿病患者相比，CMV血清学阳性且患有糖尿病的患者继发CVD事件风险大幅增加（调整后HR 2.58，95% CI 1.32 - 5.10），而仅其中任何一种情况单独存在时，风险仅呈微弱且无显著意义的增加。
我们的结果与CMV血清学阳性患者继发CVD事件风险可能适度增加一致，且表明CMV阳性糖尿病患者风险大幅增加。
