(Circulation. 1999;100:832-837.)
© 1999 American Heart Association, Inc.
Clinical Investigation and Reports |
Chlamydia pneumoniae Infection and Early Asymptomatic Carotid Atherosclerosis
From the Department of Clinical Neuroscience, King's College School of Medicine and Dentistry and Institute of Psychiatry, London, (H.S.M.); Department of Neurology, Dusseldorf University, Germany (M.S., H.S.); and Departments of Virology (D.C.) and Medicine (M.A.M.), St George's Hospital Medical School, London, UK.
Correspondence to Dr Hugh Markus, Department of Neurology, Institute of Psychiatry, De Crespigny Park, London, SE5 8AF, UK. E-mail h.markus{at}iop.kcl.uk
Background—Chronic Chlamydia pneumoniae infection has been implicated in the pathogenesis of atherosclerosis but whether it plays a role at an early stage in the disease is uncertain. An early estimate of atherosclerosis can be obtained by ultrasonic imaging of the carotid artery to determine intima-media thickness (IMT) and the thickness of any atheroma plaques.
Methods and Results—In 983 normal population individuals aged 30
to 70 years, we measured common carotid artery (CCA) and carotid bulb
IMT, and also carotid plaque thickness and the degree of internal
carotid artery (ICA) stenosis. C. pneumoniae IgA
titers of 
16 and IgG titers of 64 were taken as positive. There was
no association between C. pneumoniae IgA or IgG
seropositivity with right, left, or mean CCA or bulb IMT, or with the
presence of carotid plaques. There was a significant association
between IgA seropositivity and >50% mean carotid stenosis
with an odds ratio of 5.24 (95% CI 1.24 to 22.21,
P=0.0245) after controlling for age and sex; after
controlling for other cardiovascular risk factors, this
was not significant 3.96 (95% CI 0.84 to 18.78,
P=0.082). No association was found between IgA or IgG
seropositivity and markers of fibrinogen, log C-reactive protein, or
leukocyte count.
Conclusions—We found no evidence that serological evidence of C. pneumoniae infection is associated with early atherosclerosis. It is possible that IgA seropositivity is associated with more advanced disease but this hypothesis needs to be examined in a population with a higher prevalence of advanced atherosclerosis. We found no evidence that C. pneumoniae results in a chronic systemic inflammatory state.
Key Words: Chlamydia pneumoniae • ultrasonics • atheroma • carotid arteries • bacterial infection • inflammation
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