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Serologic markers of persistent Chlamydia pneumonia infection and long-term prognosis after successful coronary

Michael N Zairis1, Olga A Papadaki, Paraskevi K Psarogianni

  • 1Department of Cardiology, Tzanio Hospital, Piraeus, Greece. zairis@hellasnet.gr

American Heart Journal
|December 9, 2003
PubMed

Insights

Persistent Chlamydia pneumoniae (Cp) infection, indicated by positive IgA titers, is linked to higher inflammation and adverse outcomes after coronary stenting (CS) in patients with unstable coronary syndromes.

Area of Science:

  • Cardiology
  • Infectious Disease
  • Inflammation Research

Background:

  • Inflammation plays a role in late prognosis after coronary stenting (CS).
  • High preprocedural C-reactive protein (CRP) levels are associated with increased risk of late ischemic complications.
  • Persistent Chlamydia pneumoniae (Cp) infection may contribute to this inflammation and adverse outcomes post-CS.

Purpose of the Study:

  • To investigate the association between persistent Chlamydia pneumoniae (Cp) infection and late clinical outcomes after coronary stenting (CS).
  • To evaluate the relationship between Cp infection, inflammation markers (CRP), and disease progression in patients undergoing CS.

Main Methods:

  • A cohort of 483 patients with stable or unstable coronary syndromes underwent successful CS and were followed for 1 year.
  • The study assessed a composite clinical endpoint, in-stent restenosis, and coronary artery disease progression.
  • Preprocedural anti-Cp IgA and IgG titers, along with plasma CRP levels, were measured.

Main Results:

  • Positive IgA anti-Cp titers correlated with high CRP levels in unstable coronary syndromes (P=.005), but not stable angina.
  • Positive IgA titers were significantly associated with increased risk of the composite clinical endpoint (P=.04) and coronary artery disease progression (P<.001) in unstable patients.
  • Neither IgA nor IgG titers predicted in-stent restenosis rates.

Conclusions:

  • Persistent Chlamydia pneumoniae (Cp) infection may drive coronary inflammation.
  • Cp infection portends an adverse late outcome in patients with unstable coronary syndromes undergoing CS.
  • The findings highlight the potential impact of infectious agents on cardiovascular disease prognosis.
Abstract

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