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(Circulation. 2000;102:2335.)
© 2000 American Heart Association, Inc.
Clinical Investigation and Reports |
Chlamydia pneumoniae, Herpes Simplex Virus Type 1, and Cytomegalovirus and Incident Myocardial Infarction and Coronary Heart Disease Death in Older Adults
The Cardiovascular Health Study
Presented in part at the American Heart Association Council on Epidemiology and Prevention Scientific Sessions, Santa Fe, NM, March 1998.
From the Departments of Medicine (D.S.S., B.M.P., L.C.), Epidemiology (D.S.S., B.M.P., S.M.S., J.T.G.), Health Services (B.M.P.), Pathobiology (J.T.G., S.P.W.), Biostatistics (R.A.K.), and Laboratory Medicine (L.C., R.A.), University of Washington and Fred Hutchinson Cancer Research Center (S.M.S., L.C.) (Seattle); Department of Epidemiology (L.H.K.), University of Pittsburgh, Pittsburgh, Pa; and Department of Pathology (R.P.T.), University of Vermont (Burlington).
Background—Whether serological evidence of prior infection with Chlamydia pneumoniae, herpes simplex virus type 1 (HSV-1), and cytomegalovirus (CMV) is associated with myocardial infarction (MI) and coronary heart disease (CHD) death remains a source of controversy.
Methods and Results—We conducted a nested case-control study
among participants in the Cardiovascular Health Study,
a cohort study of persons aged 
65 years. Cases experienced an
incident MI and CHD death (n=213). Control subjects were matched to
cases by age, sex, clinic, year of enrollment, and month of blood draw
(n=405). Serum was analyzed for IgG antibodies to C
pneumoniae, HSV-1, and CMV. After adjustment for other risk
factors, the risk of MI and CHD death was associated with the presence
of IgG antibodies to HSV-1 (odds ratio [OR] 2.0, 95% CI 1.1 to 3.6)
but was not associated with the presence of IgG antibodies to either
C pneumoniae (OR 1.1, 95% CI 0.7 to 1.8) or CMV (OR
1.2, 95% CI 0.7 to 1.9). Although there was little association with
low to moderate C pneumoniae antibody titers (
1:512),
high-titer (1:1024) C pneumoniae antibody was associated
with an increased risk (OR 2.2, 95% CI 1.1 to 4.4).
Conclusions—Among older adults, the presence of IgG antibodies to HSV-1 was associated with a 2-fold increase in the risk of incident MI and CHD death. For C pneumoniae, only high-titer IgG antibodies were associated with an increased risk of MI and CHD death. The presence of IgG antibodies to CMV was not associated with risk among the elderly.
Key Words: bacteria • viruses • myocardial infarction • coronary heart disease • aging
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