Cytomegalovirus infection and coronary artery disease: A single-center serological study in northwestern Iran

The role of chronic Cytomegalovirus (CMV) infection and inflammation in
the pathogenesis of atherosclerosis and Coronary Artery Disease (CAD) is still not clear.
Objectives: This study aimed to explore the seroprevalence of anti-CMV antibodies and
inflammatory markers in patients with stable angina who had undergone diagnostic
coronary angiography for clinical suspicion of CAD.
Patients and Methods: This cross-sectional, descriptive study was conducted on
181 patients with stable angina selected randomly among the patients referred to
Seyyedoshohada Heart Hospital of Urmia, Iran for diagnostic coronary angiography
between August 2012 and December 2013. The patients were categorized into CAD
and non-CAD groups based on their angiographic findings. Then, anti-CMV IgG and
IgM antibodies were tested using the Enzyme-Linked Immunosorbent Assay (ELISA)
method (Diapron, Rome, Italy). Serum C-Reactive Protein (CRP) was also measured by
a qualitative method (Aniston Kit).
Results: Based on angiographic findings, 141 patients (77.9%) had atheromatous plaques
in their coronary arteries, while coronary arteries were free of any plaques in 40 cases
(22.1%). Besides, 99.3% of the patients in the CAD group and all the patients in the
non-CAD group were anti-CMV IgG positive. The rate of anti-CMV IgM seropositivity
was 11.7% in the CAD group and 13.2% in the non-CAD group (P = 0.78). However, no
significant difference was observed between the groups with and without angiographicallydocumented
CAD in terms of CRP seropositivity (64.7% vs. 56.4%, P = 0.34).
Conclusions: Regardless of having angiographically-proven CAD, almost all the cases
referred for coronary angiography in our study had a previous exposure to CMV infection
as determined by the presence of anti-CMV IgG antibodies in their sera. In fact, the results
indicated no significant associations between CMV infection and the presence of CAD