459 CMV Antibody Level is an Independent Risk Factor for MACCE and Death in the General Population

Abstract

Cytomegalovirus (CMV) infections have been linked to increased cardiovascular disease burden in healthy adults. Previous studies have considered CMV serostatus and not antibody levels, which tend to increase with age and may reflect reactivations of latent CMV. We investigated the association between CMV antibody levels and all-cause death and major cardiovascular outcomes in a community-based cohort. CMV antibody levels were determined using an in-house enzyme-linked immunosorbent assay in stored plasma samples from 825 participants aged 58-79 years from the 1994/95 Busselton Health Study cohort with no history of cardiovascular disease. Cox regression models were used to determine the adjusted hazard ratios for CMV antibody levels as continuous predictor of all-cause death and MACCE (composite of all-cause death, acute coronary syndrome, coronary artery revascularisation procedures or ischaemic stroke) at 5 and 20 years follow-up, adjusting for conventional risk factors. Of the 825 participants, 638 (77.3%) were CMV seropositive. In the fully adjusted model, higher CMV antibody levels were associated with an increased risk of all-cause death at 5 years (HR 1.26 per 1 standard deviation (SD) increase in CMV antibody level, 95% CI 1.02-1.55) and 20 years (HR 1.12, 95% CI 1.01-1.24) follow-up. Furthermore, higher levels of CMV antibody were associated with an increased risk of MACCE at 5 years (HR 1.21 per 1 SD increase in CMV antibody, 95% CI 1.01-1.44) and 20 years (HR 1.13, 95% CI 1.03-1.24) follow-up. CMV antibody levels are independently associated with risk of death and MACCE in the general population.