Abstract
Background: Cytomegalovirus (CMV) infection has been associated with venous thromboembolism (VTE) and acute coronary syndromes (ACS).Methods: 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.Results: 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).Conclusions: This retrospective study demonstrates that CMV infection may be a significant risk factor for VTE and ACS.
Highlights
Cytomegalovirus (CMV) is a heterogeneous deoxyribonucleic acid (DNA) virus in the herpesviridae family capable of infecting a broad range of tissue types within a host [1]
Forty-nine patients were excluded due to lack of CMV immunoglobulin G (IgG), immunoglobulin M (IgM), or DNA polymerase chain reaction (PCR) testing to confirm the date of CMV diagnosis
The “seropositive control” group was defined as patients with positive CMV IgG and negative IgM or PCR
Summary
Cytomegalovirus (CMV) is a heterogeneous DNA virus in the herpesviridae family capable of infecting a broad range of tissue types within a host [1]. This virus has been associated with a wide variety of chronic diseases [2]. Reversible risk factors include recent surgery, trauma, prolonged immobility, obesity, pregnancy, estrogen use, indwelling catheters, acute infection, and current or recent hospitalization [3,4]. CMV was first described in association with venous thromboembolism in 1984. Cytomegalovirus (CMV) infection has been associated with venous thromboembolism (VTE) and acute coronary syndromes (ACS)
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