Increased incidence of cardiac complications in kidney transplant recipients with cytomegalovirus disease

Transplantation. 2000 Jul 27;70(2):310-3. doi: 10.1097/00007890-200007270-00013.

Abstract

Background: The transplant literature has not shown cytomegalovirus (CMV) disease to be a significant risk factor for posttransplant cardiac complications. A large number of nontransplant studies have, however, reported an association between coronary heart disease (CHD) and CMV disease. Pathology studies have demonstrated a high incidence of CMV in atheromatous plaques from the coronary circulation.

Methods: We performed multivariate analysis to determine if posttransplant CMV disease was a significant risk factor for cardiac complications in kidney transplant recipients. We also performed univariate analysis to determine which cardiac complications were more common in the recipients with CMV disease.

Results: Between January 1, 1984 and June 30, 1997, 1859 adults underwent kidney transplants at our institution. Of these, 377 developed one of the following cardiac complications posttransplant: myocardial infarction, angina, arrhythmia, congestive heart failure, and angiographic vessel occlusion. By multivariate analysis, significant risk factors for one of the above cardiac complications were recipient age >50 years [odds ratio (OR)=2.5, P=0.0001], diabetes (OR=1.99, P=0.0001), a history of cardiac disease pretransplant (OR= 1.34, P=0.04), and CMV disease (OR=1.5, P=0.01). Univariate analysis demonstrated that recipients with CMV disease had a higher overall incidence of cardiac complications. Arrhythmias, congestive heart failure, and vessel occlusion were more common in those with CMV disease. The incidence of myocardial infarction, angina, and cardiac arrest did not differ between the two groups (recipients with versus without CMV disease).

Conclusions: CMV disease is associated with an increased risk of cardiac complications in kidney transplant recipients. In our series, angiographic vessel occlusion was more common in recipients with CMV disease. This interesting finding may support the theory that CMV plays some role in the pathogenesis of CHD.

MeSH terms

  • Adult
  • Angina Pectoris / complications
  • Angina Pectoris / virology
  • Arrhythmias, Cardiac / complications
  • Arrhythmias, Cardiac / virology
  • Arterial Occlusive Diseases / complications
  • Arterial Occlusive Diseases / virology
  • Cohort Studies
  • Coronary Disease / complications*
  • Coronary Disease / epidemiology*
  • Coronary Disease / virology
  • Cytomegalovirus Infections / blood
  • Cytomegalovirus Infections / complications*
  • Female
  • Heart Arrest / complications
  • Heart Arrest / virology
  • Heart Failure / complications
  • Heart Failure / virology
  • Humans
  • Incidence
  • Kidney Transplantation* / adverse effects
  • Male
  • Myocardial Infarction / complications
  • Myocardial Infarction / virology
  • Postoperative Complications / blood
  • Postoperative Complications / virology