Lee Kyoung Hwa, Yoo Seul Gi, Han Kyung Do, La Yeonju, Kwon Da Eun, Han Sang Hoon
Divison of Infectious Disease, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea.
Department of Biostatistics, Catholic University College of Medicine, Seoul, Republic of Korea.
Arch Med Sci. 2021 Mar 19;18(5):1188-1198. doi: 10.5114/aoms/105157. eCollection 2022.
Anti-cytomegalovirus (CMV) IgG seropositive and/or titer are associated with a higher risk of cardiovascular diseases (CVD). However, it is not clear whether CMV end-organ disease may have a relation with development of CVD or chronic heart diseases.
In matched cohort study, the National Health Insurance Database covering 50 million people was used to identify 667 patients with CMV diseases and aged ≥ 20 years between 2010 and 2014. 6,670 control subjects without CMV diseases were matched by age, sex, type 2 diabetes mellitus (DM), hypertension, dyslipidemia, and cohort entry year. Data on CMV disease and heart disease events of myocardial infarction (MI), congestive heart failure (CHF), and atrial fibrillation (AF) were retrieved. Previous events before CMV disease or cohort entry were excluded until January 2006. Subjects were followed until December 2015 in subjects without events and until date of events in subjects with events.
The multivariate regression model adjusted by age, sex, low-income status, type 2 DM, hypertension, dyslipidemia, solid organ transplantation, and hematopoietic stem cell transplantation showed a significantly higher incidence rate of MI (odds ratio (OR) = 2.1, 95% confidence intervals (CI): 1.0-4.5) and CHF (OR = 3.8, 95% CI: 2.1-6.8) but not AF (OR = 1.9, 95% CI: 0.9-4.0) in patients with CMV disease. The age group of 40-64 years with CMV disease had the highest risk for new-onset CHF in this regression model (OR = 9.4, 95% CI: 4.12-21.44, = 0.029).
Symptomatic CMV tissue-invasive diseases were associated with a higher risk of new-onset MI and CHF.
抗巨细胞病毒(CMV)IgG血清学阳性和/或滴度与心血管疾病(CVD)风险较高相关。然而,尚不清楚CMV终末器官疾病是否与CVD或慢性心脏病的发生有关。
在一项匹配队列研究中,利用覆盖5000万人的国民健康保险数据库,识别出2010年至2014年间667例年龄≥20岁的CMV疾病患者。6670例无CMV疾病的对照者按年龄、性别、2型糖尿病(DM)、高血压、血脂异常和队列入组年份进行匹配。检索CMV疾病和心脏病事件(心肌梗死(MI)、充血性心力衰竭(CHF)和心房颤动(AF))的数据。CMV疾病或队列入组前的既往事件被排除至2006年1月。无事件的受试者随访至2015年12月,有事件的受试者随访至事件发生日期。
经年龄、性别、低收入状态、2型DM、高血压、血脂异常、实体器官移植和造血干细胞移植校正的多变量回归模型显示,CMV疾病患者发生MI(比值比(OR)=2.1,95%置信区间(CI):1.0-4.5)和CHF(OR = 3.8,95% CI:2.1-6.8)的发病率显著更高,但AF(OR = 1.9,95% CI:0.9-4.0)并非如此。在该回归模型中,40-64岁患有CMV疾病的年龄组发生新发CHF的风险最高(OR = 9.4,95% CI:4.12-21.44,P = 0.029)。
有症状的CMV组织侵袭性疾病与新发MI和CHF的较高风险相关。