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Circulating Chlamydia pneumoniae DNA as a predictor of coronary artery disease
Y K Wong1, K D Dawkins, M E Ward
1Molecular Microbiology Department, Southampton University Medical School, and Southampton General Hospital, United Kingdom. YW2@soton.ac.uk
Insights
Current Chlamydia pneumoniae (CPn) infection, indicated by CPn DNA in blood, is a predictor of coronary artery disease (CAD) in men. This finding may help identify men who could benefit from antichlamydial therapy.
Area of Science:
- Cardiovascular Medicine
- Infectious Diseases
- Molecular Diagnostics
Background:
- Chlamydia pneumoniae (CPn) has been linked to coronary artery disease (CAD) through serological, pathological, and animal studies.
- Preliminary trials suggest antibiotics may reduce adverse coronary events, supporting the investigation of CPn as a contributing factor to CAD.
- CPn is hypothesized to spread systemically within macrophages, prompting the search for direct markers of infection.
Purpose of the Study:
- To ascertain if current vascular Chlamydia pneumoniae (CPn) infection, detected via circulating CPn DNA, is more prevalent in individuals with coronary artery disease (CAD).
- To evaluate the utility of detecting CPn DNA in blood as a predictor for CAD.
- To explore potential benefits of antichlamydial therapy for specific patient groups.
Main Methods:
- A cohort of 1,205 subjects undergoing coronary arteriography was recruited.
- Blood samples were collected, and mononuclear cells and platelets were isolated.
- Polymerase chain reaction (PCR) was employed to detect the presence of CPn DNA.
Main Results:
- Circulating CPn DNA was detected in 8.8% of men with CAD versus 2.9% of men without CAD (OR 3.2, 95% CI 1.1-8.9).
- Men with CAD and CPn DNA exhibited higher mean platelet counts.
- No association between circulating CPn DNA and CAD was observed in women.
Conclusions:
- Circulating CPn DNA serves as a significant predictor of CAD in men.
- Unlike serological methods, CPn DNA detection indicates current infection, offering a specific diagnostic marker.
- This diagnostic approach can identify male patients who may benefit from antichlamydial treatment.
Objective:
To determine whether current vascular Chlamydia pneumoniae (CPn) infection as diagnosed by circulating CPn DNA is more common in subjects with coronary artery disease (CAD).
Background:
Serological, pathological and animal studies have associated CPn with CAD and preliminary trials suggest antibiotics may prevent adverse coronary events. C. pneumoniae is thought to disseminate systemically within macrophages. We therefore detected CPn DNA in blood to determine whether its presence was a predictor of CAD.
Methods:
One thousand, two hundred and five subjects attending for diagnostic and interventional coronary arteriography were recruited. The mononuclear cell layer and platelets were separated from collected blood and the polymerase chain reaction (PCR) was used to detect CPn DNA.
Results:
Circulating CPn DNA was found in 8.8% of 669 men with CAD compared with 2.9% of 135 men with normal coronary arteries (odds ratio [OR] 3.2, 95% confidence interval [CI] 1.1-8.9). In men with CAD, those with CPn DNA had higher mean platelet counts than those without CPn DNA. Monocyte counts and indirect fibrinogen levels were also raised but not significantly so. By contrast, no association of circulating CPn DNA and CAD was seen in women.
Conclusions:
Circulating CPn DNA is a predictor of CAD in men. Unlike serology, it is a specific indicator of current infection and is a means of identifying subjects who may potentially benefit from antichlamydial therapy.