Association between TTV viremia, chronic inflammation, and ischemic heart disease risk: Insights from MARK-AGE and Report-Age projects

The implication of Torquetenovirus (TTV) in Ischemic Heart Disease (IHD) has not been thoroughly explored. This study investigated the association between TTV viremia, proinflammatory cytokines, and IHD risk in an aging population. This cross-sectional study included 900 non-IHD subjects (NIHD) and 86 individuals with IHD (aged 55 to 75 years) selected from the MARK-AGE project. Results were verified in another independent Report-Age cohort, including 94 inpatients with chronic IHD and 111 inpatients with no evidence of IHD (NIHD) (aged 65 to 96 years). Multivariable logistic regression in the MARK-AGE cohort revealed that male sex, TTV viremia ≥4log, Cu/Zn ratio, diabetes, hypertension and smoking were significant IHD predictors. Notably, TTV viremia ≥4log independently increased the IHD risk (OR: 2.51, 95% CI: 1.42-4.43), confirmed in the Report-Age cohort (OR: 4.90, 95% CI: 2.32-10.39). In a RASIG subgroup, individuals with TTV viremia ≥4log, both with and without IHD, exhibited increased plasma pro-inflammatory cytokine levels (IFN-γ, IL-1β, IL-6, IL-10, IL-12p70, TNF-α) compared to those with TTV viremia < 4log. No significant difference in cytokine production was observed between IHD patients and NIHD with TTV viremia ≥4log. A positive correlation between TTV viremia and DNA methylation estimator of leukocyte telomere length was observed in Report-Age patients. Additionally, IHD Report-Age patients with TTV viremia ≥4log displayed higher NLR and SIRI index than those with TTV viremia < 4log. In conclusion, a high TTV viremia is associated with an elevated IHD risk in the older population, potentially arising from an augmented proinflammatory response and immunosenescence