Coronary Artery Disease And Infection With Chlamydia Pneumoniae

Cardiovascular disease is a major cause of morbidity and mortality worldwide. The cause is multifactorial. A substantial proportion of pa-tients with coronary heart disease (CHD) do not have traditional risk factors. Infections disease may play a role in these cases, or they may intensify the effect of other risk factors. The association of CHD and chlamydia pneumoniae is firmly established, but causality is yet to be proven. CP is a common respiratory pathogen causing community -acquired pneumoniae, bronchitis, sinusitis and upper respiratory tract symptoms. The infection is frequently mild and clinically unapparent.Since 1988, Saikku and co -workers, have shown an association between CP infection and arteriosclerosis. Most of the epidemiological studies of CP antibodies and CHD supported the existence of an asso-ciation between them; yet, it is still a matter of debate. This link has become more persuasive by the identification of CP elementary bodies in atherosclerotic plaques and fatty streaks in autopsy cases from the a-orta and coronary arteries. The organism is rarely found in vascular specimens from non - atherosclerotic patients or those with nonathero-genic arteriopathy. To appreciate the possible role of infectious disease, it is necessary to understand the pathogenesis of arteriosclerosis. We therefore investigated the presence of IgG antibodies against CP in the blood samples of patients with CHD, and its relation with levels of?ood lipids and inflammatory markers was studied.MethodsPatientsWe selected 60 patients with angiographically proven coronary ar-tery disease. We also selected 60 normotensive subjects as a control group. Their ages, all gender, body mass indexes, smoking and alco-hol habits were weU matched to each other. All of the patients had an-giographic documentation of a coronary stenosis 5=50% at least one coronary artery. Ah1 underwent resting exclusion an immunological dis-ease and infectious disease in the last 6 month.Measurements of Blood SamplesBlood was drawn by venipuncture. Seum from all patients was an-alysed for total cholesterol ( TC) , HDL - cholesterol ( HDL - C ) , tri-glycerides ( TG) , LDL - cholesterol ( LDL - C ). Plasma was ana-lysed for fibrinogen levels. Serum from all cases was analysed for the presence of anti CP antibodies. The results are expressed as enzyme imm unounits (EIU). The labsystemCP IgG El A kit was used to de-tect the positivity treshold EIUs at EIU > 30ElUsample = 130 x ( Asample - Ablank)/ Acal - AblankAsample = absorbance of the sampleAblank = absorbance of the blankAcal = absorbance of the calibratorEIU < 30 NegativeEIU ≥30 PostitiveStatistical analysisData are expressed as the mean X ?SD. Analysis was done using a 2 - sample independent ?test and chi - square test for comparison of 2 groups. Pearsons correlation analysis was used to show the relation between variables and anti CP IgG seropositivity in the patients of CHD. Probability values of <0.. 05 were accepted as statistically sig-nificant.ResultsTable I shows baseline clinical characteristics of the patient and the control groups. There were no significant differences in age, sex, BMI, blood pressure levels, smoking habit or alcohol consumption ( P >0.05).In the CHD positive group TG ( mg/dl) , LDL - C ( mg/dl) , and fibrinogen levels were higher than the negative cases. The level of HDL - C was lower. The level of TC did not differ between the groups (P > 0. 05) (table IV) - While the levels of TG LDL - C, Fg show a positive relation with the presence of anti CP IgG antibody the HDL -cholesterol level showed an negative relation.DiscussionAn inflammatory basis to arteriosclerosis is now accepted. It re-mains plausible (but unproven) that common infections agents may contribute to the progression of arteriosclerosis. Evidence for this is based on sero - epidemiological, pathological and animal models evi-dence of the candidate microorganisms implicated, CP has emerged as...