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[Study on the correlation of between infection, inflammation and coronary artery disease]
Xiao-jie Cai1, Hua-bo Cai, Duan Lu
1Department of Cardiology, Sir Run Run Shaw Hospital, Hangzhou 310016, China.
Insights
Infections by Chlamydia pneumoniae (Cp) and Helicobacter pylori (Hp) are linked to coronary artery disease (CAD) risk. C-reactive protein (CRP) is an independent CAD marker, but not directly linked to these specific infections.
Area of Science:
- Cardiovascular Medicine
- Infectious Diseases
- Immunology
Background:
- Atherosclerosis development is potentially influenced by infections like Chlamydia pneumoniae (Cp), Helicobacter pylori (Hp), and cytomegalovirus (CMV).
- Understanding the interplay between these infections, systemic inflammation, and coronary artery disease (CAD) is crucial for public health.
Purpose of the Study:
- To investigate the association between Cp, Hp, and CMV infections, systemic inflammation (measured by C-reactive protein - CRP), and the presence of coronary artery disease (CAD).
Main Methods:
- A case-control study involving 45 patients with significant coronary artery stenosis and 33 controls with normal coronary angiography.
- Measurement of antibodies against Cp, Hp, and CMV, along with serum CRP levels, in all participants.
- Definition of elevated CRP level as > 0.8 mg/dl.
Main Results:
- Prevalence of Cp IgG, Hp IgG, or Hp IgA antibodies was significantly associated with CAD, even after adjusting for major cardiovascular risk factors.
- Mean CRP levels were significantly higher in CAD patients compared to controls, with elevated CRP being an independent CAD parameter.
- No significant association was found between Cp, Hp, or CMV IgG antibodies and elevated CRP levels, nor between CMV infection and CAD.
Conclusions:
- Chronic infections with Cp and Hp may elevate the risk of developing CAD.
- CMV infection does not appear to be associated with CAD.
- While CRP is an independent predictor of CAD, the systemic inflammation observed in CAD patients in this study was not directly linked to the investigated infections.
Objective:
Recently studies showed infections of Chlamydia pneumoniae (Cp), Helicobacter pylori (Hp) and cytomegalovirus (CMV) played roles in the development of atherosclerosis. The aim of this study was to study relationship between infection of Cp, Hp and CMV, systemic inflammation and coronary artery disease (CAD).
Methods:
Fourty-five patients with at least one coronary artery stenosis > 50% and 33 control subjects with negative coronary angiography were recruited for this case-control study from May 2000 to October 2001. Antibodies against Cp, Hp and CMV were measured and serum C-reactive protein (CRP) levels determined for each case. CRP level > 0.8 mg/dl was defined at elevated CRP level.
Results:
The prevalence of Cp IgG, Hp IgG or Hp IgA antibody was associated with CAD (P = 0.017, P < 0.001, P = 0.009). After adjustment for age, gender, smoking, hypertension, hyperlipidemia and diabetes, the association was still seen. Mean CRP value was significantly higher in patients with CAD, compared to those without CAD (P < 0.001). Multivariate analysis showed statistical significance (P = 0.03). Elevated levels of CRP were found to be an important parameter for CAD (P = 0.032). The prevalence of Cp IgG antibody, Hp IgG and CMV IgG antibody all showed no association with elevated levels of CRP (P = 0.391, P = 0.253, P = 0.724). The ratio of elevated levels of serum basic CRP in the group with IgG antibodies to 3 pathogens was 32.1% while in the group with IgG antibodies to
Conclusions:
Two chronic infections, Cp and Hp, might increase the risk of CAD. There was no association of CMV infection with CAD. C-reactive protein was an independent parameter of CAD, but the increased systemic inflammation in CAD did not seem to be related to aforesaid infection.