Role of infection as a risk factor for atherosclerosis, myocardial infarction, and stroke

Area of Science:

• Cardiovascular Science
• Infectious Disease Epidemiology

Background:

• Growing evidence links microbial infections to atherosclerosis and thrombosis.
• Herpesviruses are implicated in experimental atherosclerosis and found in human lesions.
• Other infections like Chlamydia pneumoniae and dental infections are associated with coronary heart disease and stroke.

Purpose of the Study:

• To review the evidence linking various infections to atherosclerosis and thrombosis.
• To explore the potential mechanisms by which infections contribute to cardiovascular disease.
• To highlight the role of specific pathogens and inflammatory markers.

Main Methods:

• Review of existing scientific literature and observational studies.
• Analysis of data linking specific infections (e.g., herpesviruses, Chlamydia pneumoniae) to cardiovascular conditions.
• Examination of proposed pathophysiological mechanisms involving inflammatory and hemostatic pathways.

Main Results:

• Herpesviruses experimentally induce atherosclerosis and are detected in human atherosclerotic lesions.
• Cytomegalovirus is found in restenosis lesions post-angioplasty, alongside p53.
• Chlamydia pneumoniae, dental, and respiratory infections correlate with coronary heart disease and ischemic stroke.
• Infections may increase fibrinogen, leukocytes, clotting factors, and cytokines, and alter endothelial cell and macrophage function.
• Low-grade infections may contribute to the inflammation seen in atherosclerotic lesions and acute ischemic events, indicated by elevated C-reactive protein.

Conclusions:

• Infections represent a significant contributing factor to the development of atherosclerosis and thrombosis.
• Further research is warranted to fully elucidate the complex interplay between infections and cardiovascular disease.
• Understanding these links may offer new avenues for prevention and treatment strategies.