Previous cytomegalovirus infection and restenosis after coronary stent placement

Background-Reactivated cytomegalovirus may promote neointima formation afte r percutaneous coronary interventions by facilitating cell cycle progressio n through inhibition of the eukariotic tumor suppressor protein p53. This p rospective study sought to investigate the effect of previous cytomegalovir us infection on restenosis after coronary stenting. Methods and Results-In 551 consecutive patients with successful stent place ment, we determined cytomegalovirus IgG titers. Primary and secondary end p oints were the rate of angiographic restenosis at 6 months and the rate of target vessel reintervention at 1 year, respectively. Three hundred forty p atients (62%) had a positive cytomegalovirus. IgG titer. We obtained angiog raphic follow-up in 82% of all patients. Angiographic restenosis rate was 2 8.7% in patients with positive cytomegalovirus. titers and 34.6% in patient s with negative titers (P=0.18). Between the groups with and without positi ve cytomegalovirus titers, there were no significant differences in late lu men loss (1.16 +/-0.90 mm and 1.23 +/-0.86 mm, respectively, P=0.44). Targe t vessel reintervention was performed in 16.8% of the patients with positiv e cytomegalovirus titers and in 17.5% of those without (P=0.82). Even after correction for potential confounding variables by multivariate analysis, p ositive cytomegalovirus titers did not manifest as a predictor of angiograp hic restenosis (adjusted odds ratio [95% confidence interval], 0.78 [0.52 t o 1.19]). Conclusions-Previous cytomegalovirus infection does not carry an increased risk of restenosis after stenting.