This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Bartels, C. Articles by Sievers, H.-H. Search for Related Content PubMed PubMed Citation Articles by Bartels, C. Articles by Sievers, H.-H. Related Collections Risk Factors CV surgery: coronary artery disease Chronic ischemic heart disease

(Circulation. 2000;101:137.)
© 2000 American Heart Association, Inc.

Clinical Investigation and Reports

Association of Serology With the Endovascular Presence of Chlamydia pneumoniae and Cytomegalovirus in Coronary Artery and Vein Graft Disease

Claus Bartels, MD; Matthias Maass, MD; Gregor Bein, MD; Nicole Brill, MD; J. F. Matthias Bechtel, MD; Rainer Leyh, MD; Hans-Hinrich Sievers, MD

From the Clinic for Cardiac Surgery (C.B., N.B., J.F.M.B., R.L., H.-H.S.) and Institute of Medical Microbiology (M.M.), University of Luebeck, Luebeck, Germany. Dr Bein currently is at the Institute of Immunology and Transfusion Medicine, University of Giessen, Giessen, Germany.

Correspondence to C. Bartels, MD, Clinic for Cardiac Surgery, Medical University of Lübeck, Ratzeburger Allee 160, 23538 Lübeck, Germany.

Background—Chemotherapeutic treatment for patients with symptomatic coronary artery disease to reduce cardiovascular events may be initiated in response to elevated antibody titers against Chlamydia pneumoniae or cytomegalovirus. How antibody titers are associated with the endovascular presence of these microorganisms is still unclear.

Methods and Results—Antibody titers against C pneumoniae (microimmunofluorescence) and cytomegalovirus (ELISA) in patients undergoing primary (coronary desobliterates, n=80) or repeated CABG (occluded vein grafts, n=45) were correlated with the endovascular presence of the 2 microorganisms. C pneumoniae was detected by means of a nested polymerase chain reaction (PCR) and by culturing. Both conventional PCR and quantitative PCR were applied for detection of cytomegalovirus. C pneumoniae (PCR/culture) was detected in 19/9% (15/80 and 7/80) of coronary desobliterates and in 18/11% (8/45 and 5/45) of occluded vein grafts. There was no statistical evidence that IgG values differed between patients with or without C pneumoniae detection who were undergoing primary CABG. In contrast, repeated-CABG patients with a positive PCR (P=0.0027) or C pneumoniae culture (P=0.0018) had distinctly elevated IgG titers compared with patients in whom C pneumoniae was not detected. Cytomegalovirus could not be detected in the examined specimens.

Conclusions—Cytomegalovirus infection does not seem to be associated with advanced coronary artery lesions. C pneumoniae antibody titers are not associated with the endovascular presence of C pneumoniae in patients with coronary artery disease. The observed strong association between elevated IgG titers and the detection of C pneumoniae in occluded vein grafts warrants further investigation.

Key Words: Chlamydia pneumoniae • viruses • coronary disease

This article has been cited by other articles:

				S. Bunk, I. Susnea, J. Rupp, J. T. Summersgill, M. Maass, W. Stegmann, A. Schrattenholz, A. Wendel, M. Przybylski, and C. Hermann Immunoproteomic Identification and Serological Responses to Novel Chlamydia pneumoniae Antigens That Are Associated with Persistent C. pneumoniae Infections J. Immunol., April 15, 2008; 180(8): 5490 - 5498. [Abstract] [Full Text] [PDF]

				Q. Xiao, K. Mandal, G. Schett, M. Mayr, G. Wick, F. Oberhollenzer, J. Willeit, S. Kiechl, and Q. Xu Association of Serum-Soluble Heat Shock Protein 60 With Carotid Atherosclerosis: Clinical Significance Determined in a Follow-Up Study Stroke, December 1, 2005; 36(12): 2571 - 2576. [Abstract] [Full Text] [PDF]

				R. Mitusch, J. Luedemann, W. G. Wood, K. Berger, U. Schminke, M. Suter, C. Kessler, U. John, J. Rupp, M. Kentsch, et al. Asymptomatic Carotid Atherosclerosis Is Associated With Circulating Chlamydia pneumoniae DNA in Younger Normotensive Subjects in a General Population Survey Arterioscler Thromb Vasc Biol, February 1, 2005; 25(2): 386 - 391. [Abstract] [Full Text] [PDF]

				M. M. Ieven and V. Y. Hoymans Involvement of Chlamydia pneumoniae in Atherosclerosis: More Evidence for Lack of Evidence J. Clin. Microbiol., January 1, 2005; 43(1): 19 - 24. [Full Text] [PDF]

				B. Maraha, H. Berg, M. Kerver, S. Kranendonk, J. Hamming, J. Kluytmans, M. Peeters, and A. van der Zee Is the Perceived Association between Chlamydia pneumoniae and Vascular Diseases Biased by Methodology? J. Clin. Microbiol., September 1, 2004; 42(9): 3937 - 3941. [Abstract] [Full Text] [PDF]

				B. Ludewig, P. Krebs, and E. Scandella Immunopathogenesis of atherosclerosis J. Leukoc. Biol., August 1, 2004; 76(2): 300 - 306. [Abstract] [Full Text] [PDF]

				W. J. Jabs, E. Theissing, M. Nitschke, J.F. M. Bechtel, M. Duchrow, S. Mohamed, B. Jahrbeck, H.-H. Sievers, J. Steinhoff, and C. Bartels Local Generation of C-Reactive Protein in Diseased Coronary Artery Venous Bypass Grafts and Normal Vascular Tissue Circulation, September 23, 2003; 108(12): 1428 - 1431. [Abstract] [Full Text] [PDF]

				M. Porqueddu, R. Spirito, A. Parolari, M. Zanobini, G. Pompilio, G. Polvani, F. Alamanni, D. Stangalini, E. Tremoli, and P. Biglioli Lack of Association Between Serum Immunoreactivity and Chlamydia pneumoniae Detection in the Human Aortic Wall Circulation, November 19, 2002; 106(21): 2647 - 2648. [Abstract] [Full Text] [PDF]

				J. Boman and M. R. Hammerschlag Chlamydia pneumoniae and Atherosclerosis: Critical Assessment of Diagnostic Methods and Relevance to Treatment Studies Clin. Microbiol. Rev., January 1, 2002; 15(1): 1 - 20. [Abstract] [Full Text] [PDF]