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Latent Cytomegalovirus Infection Is Associated With Impaired Left Ventricular Function After ST-Segment-Elevation Myocardial Infarction

Lookup NU author(s): Dr Luke Spray, Professor Ioakim SpyridopoulosORCiD

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Abstract

BACKGROUND: Human cytomegalovirus is a herpes virus that affects most individuals globally and may increase the risk of cardiovascular disease. Whether cytomegalovirus influences outcomes after ST-segment-elevation myocardial infarction (STEMI) is unknown. Our objective was to investigate the association between latent cytomegalovirus infection and outcomes after STEMI. METHODS: This study includes 354 patients with STEMI who were recruited to T-TIME (A Trial of Low-Dose Adjunctive Alteplase During Primary PCI) and had blood samples cryopreserved. Participants underwent immediate percutaneous coronary intervention, serial cardiovascular magnetic resonance imaging at 2 to 7 days and 3 months post-STEMI, and assessment of health-related quality of life with the EuroQol 5-Dimension visual analog scale. Cytomegalovirus Ig (immunoglobulin) G titer was measured in cryopreserved baseline samples from each patient. Results were adjusted for age and other possible confounders. RESULTS: One hundred seventy-five patients (49.4%) were cytomegalovirus IgG titer-negative, 89 (25.1%) were low-positive, and 90 (25.4%) were high-positive. Patients who were cytomegalovirus-positive were older (62.5 versus 58.7 years of age) and more likely to be non-White (6.7% versus 2.3%). Myocardial reperfusion, measured by ST-segment resolution, was less successful in patients who were cytomegalovirus-positive (38.7% resolution versus 48.4%; adjusted P=0.032). Left ventricular ejection fraction was lower in patients who were cytomegalovirus-positive in the first week (42.6% versus 45.3%; adjusted P=0.006) and at 3 months (47.8% versus 49.7%; adjusted P=0.033). Over 3 months, patients who were cytomegalovirus-positive had less improvement in health-related quality of life (change in EuroQol 5-Dimension visual analog scale: +3.38 versus +9.93; adjusted P<0.001). CONCLUSIONS: Patients who are cytomegalovirus-positive with STEMI have impaired reperfusion, reduced left ventricular function, and less improvement in health-related quality of life over 3 months.

Publication metadata

Author(s): Spray L, McIntosh A, McCartney PJ, Macfarlane PW, Maznyczka A, Welsh P, Berry C, Spyridopoulos I

Publication type: Article

Publication status: Published

Journal: Journal of the American Heart Association

Year: 2025

Volume: 14

Issue: 16

Print publication date: 19/08/2025

Online publication date: 12/08/2025

Acceptance date: 09/06/2025

Date deposited: 02/09/2025

ISSN (electronic): 2047-9980

Publisher: American Heart Association

DOI: 10.1161/JAHA.124.040584

PubMed id: 40792573

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