Prior cytomegalovirus infection and the risk of restenosis after percutaneous transluminal coronary balloon angioplasty

Background-Restenosis is a common problem after all revascularization proce dures in atherosclerotic coronary arteries. Reactivated human cytomegalovir us (CMV) has been detected in tissues of restenotic vascular lesions and wa s hypothesized to be a contributing pathogenic factor. Recent data suggest an association of restenosis after optimal coronary atherectomy with CMV se rostatus, and a possible role of antiviral therapy was discussed. We theref ore tested the hypothesis that prior CMV infection might be a risk factor f or restenosis after conventional coronary balloon angioplasty (PTCA). Methods and Results-We analyzed 92 consecutive patients who had been admitt ed for control angiography after previous PTCA within a mean interval of 6 months. Anti-CMV antibodies were measured as an indicator of prior CMV infe ction and latency. The coronary angiograms before PTCA, directly after, and 6 months later were analyzed quantitatively. Sixty-five percent of the pat ients were CMV-positive. Before PTCA, the degree (meant+/-SD) of stenosis w as 69+/-10% in CMV-positive and 68+/-8.3% in CMV-negative subjects. PTCA re sulted in a residual stenosis of 39% in both groups. After 6 months, the la te 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 potent ial risk factors for restenosis, CMV serostatus was not significantly assoc iated with restenosis development. Conclusions-Our data indicate that prior CMV infection, in contrast to opti mal atherectomy, is not associated with chronic restenosis after convention al coronary balloon angioplasty, The results do not support a possible bene fit from antiviral therapy.