Infectious aetiology in acute coronary syndromes

To ascertain the relationship between seropositivity to chronic infections with Helicobacter pylori, Chlamydia pneumoniae and Cytomegalovirus (CMV) and acute coronary syndromes and association of each of these infective agent with biochemical parameters and cardiovascular risk factors.

The present study was a case-control study involving 117 patients [unstable angina (UA) n=101 and chronic stable angina (CSA) n = 16] attending cardiology clinic. The cases were aged 35-79 years and they were compared with age, sex and socio-economic status matched controls without evidence of coronary artery disease (CAD).

Fifty seven (58%) patients with UA and 9(56%) patients with CSA were seropositive for H. pylori. Sixty seven (66%) subjects with UA and 15(94%) patients with CSA subjects were seropositive for C. pneumoniae. Two (2%) patients with USA were seropositive for Cytomegalovirus (CMV). Seropositivity in normal subjects for H. pylori, C. pneumoniae and CMV was 7(43.25%), 10(62.5%) and 1(6.25%) respectively. In linear regression analysis seropositivity of CMV showed positive association with HDL-C (P< 0.05). No significant association of infective agents and coronary syndromes was observed.

Higher levels of lipids, lipoproteins, C-reactive protein and higher percentage of coronary risk factors in patients seropositive for H. pylori in UA suggests the role of infective agents in pathogenesis of atherosclerosis.