(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
This article has been cited by other articles:
 |
|
 |
|
  S.-J. Jiang, C.-C. Kuo, M. W. Berry, A. W. Lee, and L. A. Campbell Identification and Characterization of Chlamydia pneumoniae-Specific Proteins That Activate Tumor Necrosis Factor Alpha Production in RAW 264.7 Murine Macrophages Infect. Immun., April 1, 2008; 76(4): 1558 - 1564. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 I. Volanen, M. J. Jarvisalo, R. Vainionpaa, M. Arffman, K. Kallio, S. Angle, T. Ronnemaa, J. Viikari, J. Marniemi, O. T. Raitakari, et al. Increased Aortic Intima-Media Thickness in 11-Year-Old Healthy Children With Persistent Chlamydia pneumoniae Seropositivity Arterioscler. Thromb. Vasc. Biol., March 1, 2006; 26(3): 649 - 655. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. K. Njamnshi, K. N. Blackett, J. N. Mbuagbaw, F. Gumedze, S. Gupta, and C. S. Wiysonge Chronic Chlamydia pneumoniae Infection and Stroke in Cameroon: A Case-Control Study Stroke, March 1, 2006; 37(3): 796 - 799. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 L. Robman, O. Mahdi, C. McCarty, P. Dimitrov, G. Tikellis, J. McNeil, G. Byrne, H. Taylor, and R. Guymer Exposure to Chlamydia pneumoniae Infection and Progression of Age-related Macular Degeneration Am. J. Epidemiol., June 1, 2005; 161(11): 1013 - 1019. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. Paldanius, A. Bloigu, M. Alho, M. Leinonen, and P. Saikku Prevalence and Persistence of Chlamydia pneumoniae Antibodies in Healthy Laboratory Personnel in Finland Clin. Vaccine Immunol., May 1, 2005; 12(5): 654 - 659. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 K Winbeck, T Etgen, H G von Einsiedel, M Rottinger, and D Sander DWI in transient global amnesia and TIA: proposal for an ischaemic origin of TGA J. Neurol. Neurosurg. Psychiatry, March 1, 2005; 76(3): 438 - 441. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. M. Ieven, V. Y. Hoymans, J. M. Bosmans, D. Sander, K. Winbeck, J. Klingelhofer, T. Etgen, and B. Conrad Early Carotid Atherosclerosis and Chlamydia pneumoniae Seropositivity: Are There Arguments to Treat With Antibiotics? * Response Circulation, August 17, 2004; 110(7): e74 - e75. [Full Text] [PDF]
|
|
|
|
|
|
D. Sander, K. Winbeck, J. Klingelhofer, T. Etgen, and B. Conrad Progression of Early Carotid Atherosclerosis Is Only Temporarily Reduced After Antibiotic Treatment of Chlamydia pneumoniae Seropositivity Circulation, March 2, 2004; 109(8): 1010 - 1015. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. J. Lindsberg and A. J. Grau Inflammation and Infections as Risk Factors for Ischemic Stroke Stroke, October 1, 2003; 34(10): 2518 - 2532. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. Liuba, E. Pesonen, I. Paakkari, D. Sander, K. Winbeck, J. Klingelhofer, T. Etgen, and B. Conrad Chlamydia pneumoniae, Antibiotic Treatment, and Early Atherosclerosis * Response Circulation, June 10, 2003; 107 (22): e205 - e205. [Full Text] [PDF]
|
|
|
|
 |
|
 Y. Agmon, B. K. Khandheria, I. Meissner, T. M. Petterson, W. M. O'Fallon, T. J. H. Christianson, D. O. Wiebers, T. F. Smith, J. M. Steckelberg, and A. J. Tajik Lack of association between Chlamydia pneumoniae seropositivity and aortic atherosclerotic plaques: A Population-Based transesophageal echocardiographic study J. Am. Coll. Cardiol., May 7, 2003; 41(9): 1482 - 1487. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 P Zarco Aortic stenosis Eur. Heart J., January 2, 2003; 24(2): 133 - 135. [Full Text] [PDF]
|
|
|
|
|
|
F.-J. Neumann Chlamydia pneumoniae-Atherosclerosis Link: A Sound Concept in Search for Clinical Relevance Circulation, November 5, 2002; 106(19): 2414 - 2416. [Full Text] [PDF]
|
|
|
|
|
|
D. Sander, K. Winbeck, J. Klingelhofer, T. Etgen, and B. Conrad Reduced Progression of Early Carotid Atherosclerosis After Antibiotic Treatment and Chlamydia pneumoniae Seropositivity Circulation, November 5, 2002; 106(19): 2428 - 2433. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. Espinola-Klein, H.-J. Rupprecht, S. Blankenberg, C. Bickel, H. Kopp, A. Victor, G. Hafner, W. Prellwitz, W. Schlumberger, and J. Meyer Impact of Infectious Burden on Progression of Carotid Atherosclerosis Stroke, November 1, 2002; 33(11): 2581 - 2586. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. R. Crouse III, R. Tang, M. A. Espeland, J. G. Terry, T. Morgan, and M. Mercuri Associations of Extracranial Carotid Atherosclerosis Progression With Coronary Status and Risk Factors in Patients With and Without Coronary Artery Disease Circulation, October 15, 2002; 106(16): 2061 - 2066. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J.A. Erkens, O.H. Klungel, R.M.C. Herings, R.P. Stolk, J.A. Spoelstra, D.E. Grobbee, and H.G.M. Leufkens Use of fluorquinolones is associated with a reduced risk of coronary heart disease in diabetes mellitus type 2 patients Eur. Heart J., October 2, 2002; 23(20): 1575 - 1579. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 F. Weber Risk factors for subclinical carotid atherosclerosis in healthy men Neurology, August 27, 2002; 59(4): 524 - 528. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K. Kohara, Y. Tabara, Y. Yamamoto, M. Igase, and T. Miki Chlamydia pneumoniae Seropositivity Is Associated With Increased Plasma Levels of Soluble Cellular Adhesion Molecules in Community-Dwelling Subjects: The Shimanami Health Promoting Program (J-SHIPP) Study Stroke, June 1, 2002; 33(6): 1474 - 1479. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C. Hermann, K. Graf, A. Groh, E. Straube, and T. Hartung Comparison of Eleven Commercial Tests for Chlamydia pneumoniae-Specific Immunoglobulin G in Asymptomatic Healthy Individuals J. Clin. Microbiol., May 1, 2002; 40(5): 1603 - 1609. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. Vainas, H. A.J.M. Kurvers, W. H. Mess, R. d. Graaf, R. Ezzahiri, J. H.M. Tordoir, G.-W. H. Schurink, C. A. Bruggeman, and P. J.E.H.M. Kitslaar Chlamydia pneumoniae Serology Is Associated With Thrombosis-Related but Not With Plaque-Related Microembolization During Carotid Endarterectomy Stroke, May 1, 2002; 33(5): 1249 - 1254. [Abstract] [Full Text] [PDF]
|
|