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Parameters of inflammation and infection in a community based case-control study of coronary heart disease
J De Backer1, R Mak, D De Bacquer
1Department of Cardiology, University Hospital, Ghent, Belgium.
Insights
Coronary heart disease (CHD) is linked to higher inflammation markers like C-reactive protein (CRP), independent of other risk factors. No link was found between these inflammation markers and common infectious agents in men with CHD.
Area of Science:
- Cardiology
- Immunology
- Epidemiology
Background:
- Systemic inflammatory markers are associated with coronary heart disease (CHD).
- The role of confounding factors, such as coronary risk factors and chronic infections, in this association is unclear.
Purpose of the Study:
- To investigate differences in inflammatory markers (CRP, SAA, fibrinogen) and infectious agent serostatus between men with stable CHD and controls, independent of traditional risk factors.
- To examine the relationship between inflammatory markers and serostatus for four infectious agents (H. pylori, C. pneumoniae, CMV, EBV) in CHD patients and healthy controls.
Main Methods:
- A large-scale epidemiologic survey compared 446 men with CHD history to 892 matched controls.
- Measurements included inflammatory biomarkers (CRP, fibrinogen, SAA) and antibodies against H. pylori, C. pneumoniae, CMV, and EBV, alongside classical coronary risk factors.
Main Results:
- Univariate analysis showed higher CRP, fibrinogen, and SAA in CHD cases, but no differences in infectious agent serostatus.
- Multivariate analysis confirmed significantly higher CRP in CHD cases, independent of other risk factors and medications.
- No association was found between inflammatory biomarkers and serostatus for any of the four infectious agents.
Conclusions:
- Elevated C-reactive protein (CRP) levels are independently associated with coronary heart disease (CHD) in working men.
- No link exists between inflammatory biomarkers and serostatus for H. pylori, C. pneumoniae, CMV, or EBV in this population.
Background:
increased levels of systemic inflammatory markers appear to be related to coronary heart disease (CHD) both in asymptomatic individuals and in subjects with established CHD. Whether these associations are related to confounding coronary risk factors or are explicable through chronic infectious conditions is not clear.
Objectives:
(1) to determine whether subjects with stable CHD differ from normal controls in inflammatory markers (CRP, SAA and fibrinogen) and/or in serostatus of four infectious agents (Helicobacter pylori, Chlamydia pneumoniae, CMV and EBV), independent of classical coronary risk factors. (2) To determine whether these inflammatory markers are related to the serostatus against these four infectious agents either in patients with CHD or in normal subjects.
Methods:
in a large epidemiologic survey, 446 out of 16307 men at work, aged 35-59 years, had antecedents of myocardial infarction, CABG or PTCA or had prominent Q/QS waves on their resting ECG. They were compared with double the number (n=892) of men, matched for age, educational level and industry. Inflammatory biomarkers (CRP, fibrinogen and SAA) and antibodies against H. pylori, C. pneumoniae, CMV and EBV were measured, besides classical coronary risk factors.
Results:
in univariate analyses, cases had higher CRP, fibrinogen and SAA levels than controls, but no differences were observed in serumantibody levels to any of the infectious agents. Markers of previous infections were not related to inflammatory biomarkers. In multivariate analyses CRP was significantly different between cases and controls independent of differences in other coronary risk factors and in the use of lipid lowering drugs and antiplatelet aggregants.
Conclusions:
in men at work with CHD, CRP levels are significantly different from controls, independent of known risk factors. No association was found between inflammatory biomarkers and positive serostatus against four infectious agents, neither in the patients nor in the healthy controls.