(Circulation. 2001;103:1390.)
© 2001 American Heart Association, Inc.
Clinical Investigation and Reports |
Enhanced Progression of Early Carotid Atherosclerosis Is Related to Chlamydia pneumoniae (Taiwan Acute Respiratory) Seropositivity
From the Department of Neurology, Technical University of Munich and Klinikum Chemnitz (J.K.), Germany.
Correspondence to Dr Dirk Sander, Department of Neurology, Technical University of Munich, Möhlstraße 28, 81675 München, Germany. E-mail dirk.sander{at}neuro.med.tu-muenchen.de
Background—Chlamydia pneumoniae (Cp) infection has been associated with atherosclerosis and has been proposed as a possible additional cardiovascular risk factor. However, the relationship between Cp seropositivity and the progression of early carotid atherosclerosis is not unequivocally clarified.
Methods and Results—We
evaluated the association between serological detection of Cp IgG
and/or IgA antibodies and the progression of the intima-media thickness
(IMT) of the common carotid artery using duplex ultrasonography in a
prospective study with a follow-up of 3 years in 272 consecutive
patients with cerebrovascular disease. Cp-seropositive patients showed
a significantly enhanced progression of the IMT even after adjustment
for other cardiovascular risk factors (0.12 mm/y [95% CI 0.11 to
0.14] versus 0.07 mm/y [0.05 to 0.09];
P<0.005). Patients with
increased C-reactive protein (
0.5 mg/dL) and Cp seropositivity showed
the most pronounced IMT progression. Multivariate regression analysis
revealed Cp seropositivity to be an independent risk factor for
progression of early carotid atherosclerosis. Cox proportional-hazard
regression analysis demonstrated a significantly increased rate of
cerebrovascular and cardiovascular events in patients with Cp
seropositivity, particularly in patients with increased C-reactive
protein levels.
Conclusions—Our data support the importance of chronic inflammation and infection for the early stages of atherosclerotic development.
Key Words: carotid arteries • cardiovascular diseases • atherosclerosis • Chlamydia pneumoniae
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