Cytomegalovirus, Chlamydia pneumoniae, and Helicobacter pylori IgG antibodies and restenosis after stent implantation: an angiographic and intravascular ultrasound study

Objective-To determine the impact of previous infection with cytomegaloviru s, Chlamydia pneumoniae, and Helicobacter pylori on neointimal proliferatio n after coronary angioplasty with stent implantation. Design-The study population was made up of 180 patients who had stent impla ntation in a native coronary artery with systematic angiographic and intrav ascular ultrasound (IVUS) follow up at six months. Quantitative coronary an giography was used to assess the late lumen loss. The mean area of neointim al tissue within the stent and the ratio of neointimal tissue to stent area were assessed from IVUS images. Previous cytomegalovirus, C Pneumoniae, an d H pylori infection was identified by IgG antibody determination. Results-Previous cytomegalovirus infection was detected in 50% of the popul ation, previous C pneumoniae in 18%, and previous H pylori in 33%. Mean (SD ) reference diameter was 2.94 (0.48) mm and mean minimum lumen diameter aft er stent implantation was 2.45 (0.42) mm. At six months, the mean late loss was 0.74 (0.50) mm, the mean neointimal tissue area was 3.8 (1.7) mm(2), a nd the average ratio of neointimal tissue area to stent area was 45 (18)%. None of these variables of restenosis was linked to any of the three infect ious agents. By multivariate analysis, lesion length was the variable best correlated with mean neointimal tissue area, the ratio of neointimal tissue to stent area, and late loss, explaining respectively 31%, 39%, and 8% of their variability. Conclusions-Previous infection with cytomegalovirus, C pneumoniae, or H pyl ori was not a contributing factor in the process of restenosis after stent implantation.