The Clinical Study Of Relativity Between Acute Coronary Syndrome And Human Cytomegalovirus Infection

Recently research discovers traditional dangerous factor in coronary heart disease,for example,active smoking, hyperlipidemia, hypertension,high blood sugar,still can't completely explain the cause of coronary.Clinical pathology and epidemiologies investigate to hint the infection has something to do with the occurrence, development of the coronary heart disease. Although an association between Cytomegalovirus (CMV) infection and coronary atherosclerosis has been reported, such an association is less clear for acute coronary syndromes (ACS). The purpose of this study was to investigate the pathogenic roles of CMV infection of coronary plaques in ACS.Cytomegalovirus (CMV) establishes a chronic infection in normal (immuno competent) hosts characterized by latency and intermittent shedding of infectious virus. Reactivation occurs mostly in situations of severe immunocompromise such as in transplant recipients treated with immunosuppressive drugs or in AIDS patients. In 1978 Fabricant reported that arterial lesions were found in chickens infected with a herpesvirus (Marek disease virus) .Since several years there is a accumulating evidence that certain microorganisms play a role in the pathogenesis of vascular pathology. An infectious cause of atherosclerosis fits into the generally accepted response-to-injury model of atherogenesis. The purpose of this paper is to give an overview of the knowledge about CMV and its role in vascular pathology; especially the contribution of CMV in the pathogenesis of atherosclerosis, reste- nosis and transplant associated atherosclerosis will be discussed. In addition, some important aspects of the interaction of the virus with cells of the vascular wall and some mediators involved in athero- genesis will be reviewed.Objective: To study the relationship between Acute Coronary Syndrome and human cytomegalovirus(HCMV) infection ,and between HCMV infection and some inflammation substances in relation to ACS.Methods: The 75 patients (43 males and 32 females) with co- ronary disease were defined by coronary angiographry and were divided into acute myocardial infarction(n=32), unstable angina pectoris(n=22),stable angina pectoris(n=21) and controls without coronary diseases(n=50). HCMV-DNA was detected by PCR. HCMV-IgG,IgM antibodies were detected by indirect-ELISA.The serum PAPPA,IL-6,IL-10 were measured in all patients by different methods of enzymatically amplified"two-step"sand- with-type immunoassay,double antibody radio immuno-assay,ABC-HRP.Results: 1)The positive rates of HCMV-IgG,IgM antibodies of patients with coronary heart disease were higher than those of healthy persons, so was positive rate of HCMV-DNA. 2)The level of PAPPA in acute coronary syndrome was significantly higher than stable angina pectoris and controls(P<0.05). The levels of IL-6,IL-10 in acute coronary syndrome and stable angina pectoris were significantly higher than controls(P<0.05).Conclusions: The infection of HCMV may be related to acute coronary syndrome and maybe as independent risk factor. Infla- mmatory cytokines(PAPPA IL-6) were significantly asso-ciation with acute coronary syndrome, They probablely lead to the ha- ppening of ACS by provoking or aggravating the inflammation of coronary artery.