Correlation Of Severity Of Coronary Lesions And Prognosis Of The CHD With Infection Of Chlamydia Pneumonia And Inflammatiory Reaction

Objectives: To evaluate the relationship of the severity of coronary lesions and the prognosis of PCI to Chlamydia CP-IgA, hsCRP and IL-6.Methods: 104 patients with established coronary heart disease , unstable angina and 20 normal controls accepted coronary angiography test. 90 patients of them accepting PCI operation and discharged with statins and aspirin 3-6 months were observed until 6 months after PCI. The adverse events during and after PCI were registered. Serum values of CP-IgA , hsCRP and IL-6 were measured using ELISA. The relationship of the severity of coronary lesions and the complications to serum CP-IgA, hsCRP and IL-6 was assessed. The relationship of adverse events during PCI and the outcome after PCI to serum CP-IgA, hsCRP and IL-6 was assessed.Results: The CP infection rate in the CHD group(0%) was higher than that of the control group(40.4%)(P<0.001). The mean level of serum CP-IgA of the multi-vessels disease subgroup(1.47 0.84 COI) was higher than that of the single vessels disease subgroup (0.60 0.51 COI)(P<0.01). There were positively correlated between serum CP-IgA , serum hsCRP levels and IL-6 levels (P<0.01) . In 90 patients with established coronary heart disease and unstable angina accepting PCI therapy, there were 20 patients with adverse events within 1 week after PCI (group 1) and 70 patients without adverse events within 1 week after PCI (group 2). The hsCRP levels of group 1 was 40.04 30.72mg/L, the hsCRP levels of group 2 was 25.64 19.07mg/L (P=0.012). The IL-6 levels of group 1 was 3.56 3.39mg/L, the hsCRP levels of group 2 was 1.98 2.26mg/L (P-0.017). There were 2 patients dead, 7 patients accepting revascularization therapy again within 6 months after PCI (group 3). There is no adverse events in other 71 patients (group 4). The CP-IgA levelsof group 3 was 1.75 0.75COI, the CP-IgA levels of group 4 was 1.00 0.74 COI (P=0.006). Conclusions: Levels of serum CP-IgA were associated with the severity of coronary lesions, suggesting that the inflammation reaction is part of the process of coronary lesions caused by the infection of Chlamydia pneumoniae. Levels of serum hsCRP and IL-6 are predictors of early outcome in patients undergoing PCI, suggesting that the early adverse events are markedly influenced by the preprocedural degree of inflammatory cell activation. Levels of serum CP-IgA is a predictors of later outcome in patients undergoing PCI, suggesting that the later adverse events are markedly influenced by the infection of Chlamydia pneumoniae.