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Medline ® Abstract for Reference 103

of 'Epidemiology, clinical manifestations, and treatment of cytomegalovirus infection in immunocompetent adults'

103
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Prior cytomegalovirus infection and the risk of restenosis after percutaneous transluminal coronary balloon angioplasty.
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Manegold C, Alwazzeh M, Jablonowski H, Adams O, Medve M, Seidlitz B, Heidland U, Häussinger D, Strauer BE, Heintzen MP
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Circulation. 1999;99(10):1290.
 
BACKGROUND: Restenosis is a common problem after all revascularization procedures in atherosclerotic coronary arteries. Reactivated human cytomegalovirus (CMV) has been detected in tissues of restenotic vascular lesions and was hypothesized to be a contributing pathogenic factor. Recent data suggest an association of restenosis after optimal coronary atherectomy with CMV serostatus, and a possible role of antiviral therapy was discussed. We therefore tested the hypothesis that prior CMV infection might be a risk factor for restenosis after conventional coronary balloon angioplasty (PTCA).
METHODS AND RESULTS: We analyzed 92 consecutive patients who had been admitted for control angiography after previous PTCA within a mean interval of 6 months. Anti-CMV antibodies were measured as an indicator of prior CMV infection and latency. The coronary angiograms before PTCA, directly after, and 6 months later were analyzed quantitatively. Sixty-five percent of the patients were CMV-positive. Before PTCA, the degree (mean+/-SD) of stenosis was 69+/-10% in CMV-positive and 68+/-8.3% in CMV-negative subjects. PTCA resulted in a residual stenosis of 39% in both groups. After 6 months, the late losses of luminal diameter in the CMV-positive and -negative groups were 11+/-13% and 12+/-15%, respectively (P=0.658). In an ANCOVA with 25 potential risk factors for restenosis, CMV serostatus was not significantly associated with restenosis development.
CONCLUSIONS: Our data indicate that prior CMV infection, in contrast to optimal atherectomy, is not associated with chronic restenosis after conventional coronary balloon angioplasty. The results do not support a possible benefit from antiviral therapy.
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Klinik für Gastroenterologie, Hepatologie, und Infektiologie, Institut für Medizinische Mikrobiologie und Virologie, Heinrich-Hein-Universität, Düsseldorf, Germany. manegold@bni.uni-hamburg.de
PMID