Acute coronary syndrome and chronic infection in the Cork coronary care case-control study
J Sheehan1, P M Kearney, S O Sullivan
1Department of Epidemiology and Public Health, University College Cork, Cork, Ireland.
Insights
This study found no link between chronic infections like H. pylori or C. pneumoniae and acute coronary syndrome. The cumulative burden of infection did not increase the risk of heart attacks.
Area of Science:
- Cardiology
- Infectious Diseases
- Epidemiology
Background:
- Chronic infections are suspected contributors to cardiovascular disease.
- The cumulative burden of multiple infections may influence disease risk.
Purpose of the Study:
- To investigate the association between chronic infections and acute coronary syndrome (ACS).
- To determine if a cumulative burden of infections increases ACS risk.
Main Methods:
- A community-based case-control study (5C study) involving patients and matched controls.
- Serological analysis for infections including Helicobacter pylori, Chlamydia pneumoniae, cytomegalovirus, and herpes simplex viruses.
- Logistic regression analysis to assess the risk of ACS based on infection seropositivity and burden.
Main Results:
- No significant difference in seropositivity to common infectious agents between cases and controls.
- Adjusted analyses showed no evidence of increased acute coronary syndrome risk with a higher burden of infection.
Conclusions:
- Findings do not support a direct association between specific infectious agents and acute coronary syndrome.
- No evidence suggests that the cumulative burden of infection contributes to the risk of acute coronary syndrome.
Objective:
To examine the association between chronic infection and cumulative burden of infection and acute coronary syndrome.
Design:
The 5C (Cork coronary care case-control) study was a community based case-control study. Patients and controls underwent a standard physical examination and had blood samples taken for serological analysis for Helicobacter pylori (IgG), Chlamydia pneumoniae (IgA, IgM, and IgG), cytomegalovirus (IgG), and herpes simplex virus types 1 and 2 (IgG).
Setting:
Patients were recruited from four hospitals in Cork City and Mallow Town. Controls, individually matched on age and sex, were selected by incident density sampling from the same general practices as the referent case.
Main Outcome Measures:
Age and sex adjusted and fully adjusted odds ratios for acute coronary syndrome by seropositivity and by increasing number of infections.
Results:
Cases and controls did not differ significantly in seropositivity to C pneumoniae, cytomegalovirus, herpes simplex viruses, and H pylori. In unconditional logistic regression analysis adjusted for age, sex, waist to hip ratio, smoking, physical activity, alcohol consumption, and social class there was no evidence of an increasing risk for acute coronary syndrome with increasing burden of infection.
Conclusions:
The findings do not support an association between specific infectious agents and acute coronary syndrome and do not provide evidence of a burden of infection effect.
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