ABSTRACT
Coronary intervention [PCI] with stent implantation. Seropositivity to certain infectious agents may play a role in the development of ISR through induction of chronic immunologic response. To assess the association between chronic infection with Cytomegalovirus [CMV], Chlamydia pneumoniae [Cp], and Helicobacter pylori [Hp], whether single or combined infection, and restenosis in patients undergoing coronary stenting. Forty patients with ISR [diagnosed by coronary angiography] were compared to 30 control patients who have had coronary stenting with no evidence [by angiography] of ISR. The third group composed of 20 healthy controls. Using Indirect ELISA method; detection of IgG specific antibodies in the sera of the 3 study groups for CMV, Chlamydia pneumoniae, and Helicobacter pylori were done. Patients with ISR were mainly above the age of 50 years [62.5%] with male predominance [70%]. Chronic infection with Cytomegalovirus [82.5% in ISR patients], based on serological findings, was a Significant risk factor for ISR [OR = 3.1, P = 0.03].Neither chronic infection with Cp [72 .5% in ISR patients] nor with Hp [67.5% in ISR patients] were proved as significant risk factors for ISR [OR = 1.7, P = 0.27 and OR = 1.2, P = 0.71 respectively]. Pathogen burden i.e. combined chronic infection with 2 or 3 microorganisms had no role in the development of ISR. Evaluation of patients who have higher titers of IgG antibodies specific for CMV may help to identify patients at greater risk for ISR. The IgG titer of significant risk should always be assessed by comparing to control group since it highly correlates to epidemiological attributes and technical applications