Kelkar Amar H, Loc Brian L, Tarantino Michael D, Rajasekhar Anita, Wang Huaping, Kelkar Mona, Farrell John
Division of Hematology & Oncology, University of Florida College of Medicine, Gainesville, USA.
Department of Cardiology, OSF Saint Francis Medical Center, Peoria, USA.
Cureus. 2020 Dec 18;12(12):e12161. doi: 10.7759/cureus.12161.
Cytomegalovirus (CMV) infection has been associated with venous thromboembolism (VTE) and acute coronary syndromes (ACS).
A retrospective study was conducted within the OSF HealthCare System in Peoria, IL. The objectives were to determine the incidence of acute VTE and ACS within one year of CMV testing. The "study group" included patients with positive CMV immunoglobulin M (IgM) or positive CMV polymerase chain reaction (PCR). The "seropositive control" group included patients with positive CMV immunoglobulin G (IgG) and negative IgM. The "seronegative control" group included patients with negative CMV IgG and IgM, or negative PCR.
Within one year of CMV infection, 38 of 379 patients (10.0%) developed VTE in the study group compared to 41 of 1334 patients (3.1%) in the seropositive control and 37 of 1249 (3.0%) in the seronegative control. Adjusting for age and gender, both control groups were less likely to have VTE than the study group within one year (seropositive control: odds ratio (OR) = 0.3, 95% confidence interval (CI) 0.2-0.5, p < 0.0001; seronegative control: OR = 0.4, 95% CI 0.2-0.6, p < 0.0001). ACS was more likely to occur in the study group, with the incidence of 7.7% compared to 4.7% (p < 0.0001) in the seropositive control and 1.9% (p <0.0001) in the seronegative control. Adjusting for age and gender, the seronegative control was less likely to develop ACS than the study group within one year (OR = 0.4, 95% CI 0.2-0.7, p = 0.003).
This retrospective study demonstrates that CMV infection may be a significant risk factor for VTE and ACS.
巨细胞病毒（CMV）感染与静脉血栓栓塞症（VTE）和急性冠状动脉综合征（ACS）有关。
在伊利诺伊州皮奥里亚的OSF医疗保健系统内进行了一项回顾性研究。目的是确定CMV检测后一年内急性VTE和ACS的发生率。“研究组”包括CMV免疫球蛋白M（IgM）阳性或CMV聚合酶链反应（PCR）阳性的患者。“血清反应阳性对照组”包括CMV免疫球蛋白G（IgG）阳性且IgM阴性的患者。“血清反应阴性对照组”包括CMV IgG和IgM阴性或PCR阴性的患者。
在CMV感染后的一年内，研究组379例患者中有38例（10.0%）发生VTE，而血清反应阳性对照组1334例患者中有41例（3.1%），血清反应阴性对照组1249例患者中有37例（3.0%）。在对年龄和性别进行调整后，两个对照组在一年内发生VTE的可能性均低于研究组（血清反应阳性对照组：比值比（OR）=0.3，95%置信区间（CI）0.2 - 0.5，p<0.0001；血清反应阴性对照组：OR = 0.4，95%CI 0.2 - 0.6，p<0.0001）。ACS在研究组中更易发生，发生率为7.7%，而血清反应阳性对照组为4.7%（p<0.0001），血清反应阴性对照组为1.9%（p<0.0001）。在对年龄和性别进行调整后，血清反应阴性对照组在一年内发生ACS的可能性低于研究组（OR = 0.4，95%CI 0.2 - 0.7，p = 0.003）。
这项回顾性研究表明，CMV感染可能是VTE和ACS的一个重要危险因素。
