Related Experiment Videos
Chronic infections and coronary heart disease: is there a link?
1Clinical Trial Service Unit, Nuffield Department of Clinical Medicine, University of Oxford, Radcliffe Infirmary, UK. John.danesh@balliol.ox.ec.uk
Insights
This review examines links between coronary heart disease (CHD) and infections like Helicobacter pylori, Chlamydia pneumoniae, and cytomegalovirus (CMV). Evidence suggests infections may play a role, but more research is needed to confirm causality.
Area of Science:
- Cardiovascular Science
- Infectious Disease Epidemiology
Background:
- Numerous studies suggest associations between coronary heart disease (CHD) and persistent infections.
- Key pathogens investigated include Helicobacter pylori, Chlamydia pneumoniae, and cytomegalovirus (CMV).
Purpose of the Study:
- To review epidemiological and clinical evidence linking CHD with H. pylori, C. pneumoniae, and CMV.
- To explore potential biological mechanisms underlying these associations.
Main Methods:
- Literature review of epidemiological studies.
- Analysis of clinical evidence and proposed pathogenic mechanisms.
- Assessment of confounding factors in observed associations.
Main Results:
- The association between CHD and H. pylori may be explained by unmeasured confounding factors.
- Evidence for C. pneumoniae and CHD is stronger, but the temporal relationship remains unclear.
- Limited data exists for cytomegalovirus (CMV) and atherosclerotic coronary artery disease.
Conclusions:
- The role of H. pylori in CHD requires further investigation to rule out confounding.
- Causality between C. pneumoniae infection and CHD is not definitively established.
- More research is essential to clarify the relationship between CMV and coronary artery disease.
Abstract:
A large number of studies have reported on associations of human coronary heart disease (CHD) and certain persistent bacterial and viral infections. We review the epidemiological and clinical evidence on CHD and Helicobacter pylori, Chlamydia pneumoniae, and cytomegalovirus (CMV), as well as possible mechanisms. The association between CHD and H pylori may be accounted for by residual confounding from risk factors. Although the association between C pneumoniae and CHD is stronger, the sequence of infection and disease is uncertain. As regards CMV, a limited number of patients with classic atherosclerotic coronary artery disease have been studied. Further studies are needed to resolve these uncertainties.