Abstract
Objective
To explore the potential relationship between previous influenza virus (IV) infection and acute myocardial infarction (AMI), and the mechanism of atherosclerosis, we conducted a case–control study and examined inflammatory cytokines to assess the association of previous IV infection and AMI.
Methods
A questionnaire-based survey was conducted to collect information about demographic characteristics and heart disease risk factors. Fasting blood samples were obtained to measure immunoglobulin (Ig) G antibodies to influenza virus A (IV-A), influenza virus B (IV-B), cytomegalovirus, herpes simplex virus type-1 and type-2, adenovirus, rubella virus and Chlamydia pneumoniae, and to measure the level of certain biochemistry markers: interleukin-2, 6, 10 and 18 (IL-2, 6, 10 and 18), tumor necrosis factor-α (TNF-α), interferon-γ (IFN-γ), endothelin-1 (ET-1), soluble intercellular adhesion molecule-1 (sICAM-1) and soluble vascular cell adhesion molecule-1 (sVCAM-1).
Results
Compared with the controls, the cases were more likely to have positive IgG antibodies to IV-A and IV-B [IV-A: odds ratio (OR): 3.1, 95% confidence interval (CI): 1.5–6.4; IV-B: OR: 10.2, 95% CI: 5.7–20.0]. After adjustment for potential confounding variables, the risk of AMI was still associated with the presence of IgG antibodies to IV-A (adjusted OR: 5.5, 95% CI: 1.3–23.0) and IV-B (adjusted OR: 20.3, 95% CI: 5.6–40.8). The levels of IL-2, 6, 10 and18, TNF-α, IFN-γ, ET-1, sICAM-1 and sVCAM-1 in patients with AMI were significantly higher than those of the controls (P < 0.01).
Conclusions
Our study supports the hypothesis that previous IV infection is associated with AMI. Inflammatory cytokines may take part in the development of atherosclerosis and trigger the occurrence of AMI.
Similar content being viewed by others
References
Naghavi M, Barlas Z, Siadaty S, Naguib S, Madjid M, Casscells W. Association of influenza vaccination and reduced risk of recurrent myocardial infarction. Circulation. 2000;102:3039–45.
Ross R. Atherosclerosis: an inflammatory disease. N Engl J Med. 1999;340(2):115–26.
Saikku P. Seroepidemiology in Chlamydia pneumoniae–atherosclerosis association. Eur Heart J. 2002;23(4):263–4.
Oshima T, Ozono R, Yano Y, Oishi Y, Teragawa H, Higashi Y, et al. Association of Helicobacter pylori infection with systemic inflammation and endothelial dysfunction in healthy male subjects. J Am Coll Cardiol. 2005;45:1219–22.
Badiou S, Thiebaut R, Aurillac-Lavignolle V, Dabis F, Laporte F, Cristol JP, et al. Groupe d’Epidémiologie Clinique du Sida en Aquitaine (GECSA). Association of non-HDL cholesterol with subclinical atherosclerosis in HIV-positive patients. J Infect. 2008;57(1):47–54.
Calza L, Manfredi R, Pocaterra D, Chiodo F. Risk of premature atherosclerosis and ischemic heart disease associated with HIV infection and antiretroviral therapy. J Infect. 2008;57(1):16–32.
Chiu B. Multiple infections in carotid atherosclerotic plaques. Am Heart J. 1999;138(5 Pt 2):S534–6.
Nieto FJ, Adam E, Sorlie P, Farzadegan H, Melnick JL, Comstock GW, et al. Cohort study of cytomegalovirus infection as a risk factor for carotid intimal–medial thickening, a measure of subclinical atherosclerosis. Circulation. 1996;94(5):922–7.
Siscovick DS, Schwartz SM, Corey L, Grayston JT, Ashley R, Wang SP, et al. Chlamydia pneumoniae, herpes simplex virus type 1, and cytomegalovirus and incident myocardial infarction and coronary heart disease death in older adults: the cardiovascular health study. Circulation. 2000;102:2335–40.
Zhu J, Quyyumi AA, Norman JE, Costello R, Csako G, Epstein SE. The possible role of hepatitis A virus in the pathogenesis of atherosclerosis. J Infect Dis. 2000;182(6):1583–7.
Auer J, Berent R, Weber T, Eber B. Influenza virus infection, infectious burden, and atherosclerosis. Stroke. 2002;33(2):1454–5.
Lavallée P, Perchaud V, Gautier-Bertrand M, Grabli D, Amarenco P. Association between influenza vaccination and reduced risk of brain infarction. Stroke. 2002;33:513–8.
Auer J, Leitinger M, Berent R, Prammer W, Weber T, Lassnig E, et al. Influenza A and B IgG seropositivity and coronary atherosclerosis assessed by angiography. Heart Dis. 2002;4(6):349–54.
Madjid M, Naghavi M, Litovsky S, Casscells SW. Influenza and cardiovascular disease: a new opportunity for prevention and the need for further studies. Circulation. 2003;108:2730–6.
Collins SD. Excess mortality from causes other than influenza and pneumonia during influenza epidemics. Public Health Rep. 1932;47:2159–80.
Gross PA, Hermogenes AW, Sacks HS, Lau J, Levandowski RA. The efficacy of influenza vaccine in elderly persons: a meta-analysis and review of the literature. Ann Intern Med. 1995;123(7):518–27.
Alpert JS, Thygesen K, Antman E, Bassand JP. Myocardial infarction redefined: a consensus document of the Joint European Society of Cardiology/American College of Cardiology Committee for the redefinition of Myocardial Infarction. J Am Coll Cardiol. 2000;36(3):959–69.
Expert Committee on the Diagnosis and Classification of Diabetes Mellitus. Report of the expert committee on the diagnosis and classification of diabetes mellitus. Diabetes Care. 2003;26:S5–20.
Whitworth JA, World Health Organization. International Society of Hypertension Writing Group. World Health Organization (WHO)/International Society of Hypertension (ISH) statement on management of hypertension. J Hypertens. 2003;21:1983–92.
Lai S, Fishman EK, Lai H, Pannu H, Detrick B. Serum IL-6 levels are associated with significant coronary stenosis in cardiovascularly asymptomatic inner-city black adults in the US. Inflamm Res. 2009;58(1):15–21.
Leon ML, Zuckerman SH. Gamma interferon: a central mediator in atherosclerosis. Inflamm Res. 2005;54(10):395–411.
Jha HC, Divya A, Prasad J, Mittal A. Plasma circulatory markers in male and female patients with coronary artery disease. Heart Lung. 2010;39(4):296–303.
Van Lenten BJ, Wagner AC, Nayak DP, Hama S, Navab M, Fogelman AM. C-reactive protein is a mediator of cardiovascular disease. Eur Heart J. 2010;31(17):2087–91.
Rizvi AA. Cytokine biomarkers, endothelial inflammation, and atherosclerosis in the metabolic syndrome: emerging concepts. Am J Med Sci. 2009;338(4):310–8.
Van Lenten BJ, Wagner AC, Nayak DP, Hama S, Navab M, Fogelman AM. High-density lipoprotein loses its anti-inflammatory properties during acute influenza A infection. Circulation. 2001;103:2283–8.
Van Lenten BJ, Wagner AC, Anantharamaiah GM, Garber DW, Fishbein MC, Adhikary L, et al. Influenza infection promotes macrophage traffic into arteries of mice that is prevented by D-4F, an apolipoprotein A-I mimetic peptide. Circulation. 2002;106:1127–32.
Bouwman JJ, Visseren FL, Bosch MC, Bouter KP, Diepersloot RJ. Procoagulant and inflammatory response of virus-infected monocytes. Eur J Clin Invest. 2002;32(10):759–66.
Visseren FL, Bouwman JJ, Bouter KP, Diepersloot RJ, de Groot PH, Erkelens DW. Procoagulant activity of endothelial cells after infection with respiratory viruses. Thromb Haemost. 2000;84:319–24.
Naghavi M, Wyde P, Litovsky S, Madjid M, Akhtar A, Naguib S, et al. Influenza infection exerts prominent inflammatory and thrombotic effects on the atherosclerotic plaques of apolipoprotein E-deficient mice. Circulation. 2003;107:762–8.
Nichol KL, Nordin J, Mullooly J, Lask R, Fillbrandt K, Iwane M. Influenza vaccination and reduction in hospitalizations for cardiac disease and stroke among the elderly. N Engl J Med. 2003;348(14):1322–32.
Loppnow H, Werdan K, Buerke M. Invited review: vascular cells contribute to atherosclerosis by cytokine-and innate-immunity-related inflammatory mechanisms. Innate Immun. 2008;14(2):63–87.
Kleemann R, Zadelaar S, Kooistra T. Cytokines and atherosclerosis: a comprehensive review of studies in mice. Cardiovasc Res. 2008;79(3):360–76.
Nakou ES, Liberopoulos EN, Milionis HJ, Elisaf MS. The role of C-reactive protein in atherosclerotic cardiovascular disease: an overview. Curr Vasc Pharmacol. 2008;6(4):258–70.
Haidari M, Wyde PR, Litovsky S, Vela D, Ali M, Casscells SW, et al. Influenza virus directly infects, inflames, and resides in the arteries of atherosclerotic and normal mice. Atherosclerosis. 2010;208(1):90–6.
Gurfinkel EP, de la Fuente RL, Mendiz O, Mautner B. Influenza vaccine pilot study in acute coronary syndromes and planned percutaneous coronary interventions: the FLU Vaccination Acute Coronary Syndromes (FLUVACS) Study. Circulation. 2002;105:2143–7.
Davis MM, Taubert K, Benin AL, Brown DW, Mensah GA, Baddour LM, American Heart Association, American College of Cardiology, et al. Influenza vaccination as secondary prevention for cardiovascular disease: a science advisory from the American Heart Association/American College of Cardiology. Circulation. 2006;114:1549–53.
Acknowledgments
Thanks are extended to the staff of the Medical Examination Center and the Cardiac Care Unit of the First Hospital of Harbin Medical University for their assistance. We acknowledge Dr. Wei-Min Li for his clinical advice to this study. Acknowledgement was extended to Li-Xin Jiang, Chun-Yan Lin, Lian-Ming Wang, Zhao-Zhen Xu and Li-Yan Wang for their laboratory tests and survey. This study was supported by the Natural Science Foundation (grant D200968) of Heilongjiang Province in China.
Conflict of interest
No author has any conflict of interest.
Author information
Authors and Affiliations
Corresponding author
Additional information
Responsible editor: Makoto Katori.
Electronic supplementary material
Below is the link to the electronic supplementary material.
Rights and permissions
About this article
Cite this article
Guan, X., Yang, W., Sun, X. et al. Association of influenza virus infection and inflammatory cytokines with acute myocardial infarction. Inflamm. Res. 61, 591–598 (2012). https://doi.org/10.1007/s00011-012-0449-3
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00011-012-0449-3