García-Elorriaga G, Sánchez-Barriga JJ, Ramos-Corrales MA, González-Bonilla C

Language: Spanish
References: 28
Page: 227-233
PDF size: 129.96 Kb.

ABSTRACT

Objective. The primary aim of this study was to determine whether antibodies against Chlamydophila pneumoniae in patients with acute myocardial infarction (AMI) and coronary risk factors are associated with death. Material and Methods. A cross-sectional study was conducted among 100 patients hospitalized in the Coronary Unit of Centro Medico La Raza Hospital of the Mexican Institute of Social Security, between 1999 and 2000. Subjects were males and females older than 18 years, diagnosed with AMI and coronary risk. Antibodies against Chlamydophila pneumoniae, Chlamydophila psitacii and Chlamydia trachomatis were measured using an indirect microinmunofluorescence assay. In addition, blood samples from 33 patients from the original group were taken when the patients were discharged from the hospital, and 3 months after their myocardial infarction. Data analysis consisted of geometric means and standard deviations as well as odds ratios with 95% confidence intervals. Results. Seventy percent of patients presented antibodies against Chlamydophila pneumoniae. Antibodies against Chlamydophila psitacii and Chlamydia trachomatis were not identified. No statistically significant association was found between antibodies and death in these patients with coronary risk factors and AMI. In the subgroup of 33 individuals 25 had antibodies against Chlamydophila pneumoniae and in 83% of them antibodies decreased three months after the AMI event. Conclusions. Even though patients with coronary risk factors and AMI had an increased seropositivity for Chlamydophila pneumoniae it was not significantly associated with death.

REFERENCES

1. Osler W. Diseases of the arteries. En: Osler W, ed. Modern medicine: Its theory and practice. Filadelfia: Lea & Febiger; 1908: 426-447.

2. Basinkevich AB, Shakhnovich RM, Martynova VR, Kolkova NI, Rakovskaya IV, Karazhas NV et al. [Role of Chlamydia, mycoplasma and cytomegalovirus infection in the development of coronary artery disease]. Kardiologiia 2003;43:4-9.

3. Saikku P, Leinonen M, Tenkanen L, Linnanmaki E, Ekman MR, Manninen V et al. Chronic Chlamydia pneumoniae infection as a risk factor for coronary heart disease in the Helsinki Heart Study. Ann Intern Med 1992;116:273-278.

4. Miettinen H, Lehto S, Saikku P, Haffner SM, Ronnemaa T, Pyorala K et al. Association of Chlamydia pneumoniae and acute coronary heart disease events in non-insulin dependent diabetic and non-diabetic subjects in Finland. Eur Heart J 1996;17:682-688.

5. Hahn DL, Golubjatnikov R. Smoking is a potential confounder of the Chlamydia pneumoniae-coronary artery disease association. Arterioscler Thromb 1992;12:945-947.

6. Karvonen M, Tuomilehto J, Pitkaniemi J, Naukkarinen A, Saikku P. Importance of smoking for Chlamydia pneumoniae seropositivity. Int J Epidemiol 1994;23:1315-1321.

7. Wolf SC, Mayer O, Jurgens S, Vonthein R, Schultze G, Risler T et al. Chlamydia pneumoniae IgA seropositivity is associated with increased risk for atherosclerotic vascular disease, myocardial infarction and stroke in dialysis patients. Clin Nephrol 2003;59:273-279.

8. Strachan DP, Carrington D, Mendall MA, Ballam L, Morris J, Butland BK et al. Relation of Chlamydia pneumoniae serology to mortality and incidence of ischaemic heart disease over 13 years in the caerphilly prospective heart disease study. BMJ 1999;318:1035-1039.

9. Haubitz M, Votsch K, Woywodt A, Nashan B, Groh A, Haller H et al. Serologic evidence of Chlamydia pneumoniae infection as a long-term predictor of cardiovascular death in renal transplant recipients. Transplantation 2004;77:1517-1521.

10. Stone AF, Mendall MA, Kaski JC, Edger TM, Risley P, Poloniecki J et al. Effect of treatment for Chlamydia pneumoniae and Helicobacter pylori on markers of inflammation and cardiac events in patients with acute coronary syndromes: South Thames Trial of Antibiotics in Myocardial Infarction and Unstable Angina (STAMINA). Circulation 2002;106:1219-1223.

11. Cosentini R, Blasi F, Raccanelli R, Rossi S, Arosio C, Tarsia P et al. Severe community-acquired pneumonia: A possible role for Chlamydia pneumoniae. Respiration 1996;63:61-65.

12. Kauppinen MT, Saikku P, Kujala P, Herva E, Syrjala H. Clinical picture of community-acquired Chlamydia pneumoniae pneumonia requiring hospital treatment: A comparison between chlamydial and pneumococcal pneumonia. Thorax 1996;51:185-189.

13. Wang S. The microimmunofluorescence test for Chlamydia pneumoniae infection: Technique and interpretation. J Infect Dis 2000;181 Suppl 3:S4215.

14. García-Elorriaga GL, Calderón-Abbo M, González-Bonilla CR.Asociación entre enfermedad cardiovascular y anticuerpos contra Chlamydia pneumoniae. Salud Publica Mex 2002;44:243-246.

15. Bloemenkamp DG, Mali WP, Visseren FL, van der Graaf Y. Metaanalysis of sero-epidemiologic studies of the relation between Chlamydia pneumoniae and atherosclerosis: Does study design influence results? Am Heart J 2003;145:409-417.

16. Di Tano G, Picerno I, Calisto ML, Delia SA, Lagana P, Spataro P. [Chlamydia pneumoniae and Helicobacter pylori infections in acute myocardial infarction]. Ital Heart J Suppl 2000;1(12):1576-1581.

17. Alpert JS, Thygesen K, Antman E, Bassand JP. Myocardial infarction redefined-A consensus document of The Joint European Society of Cardiology/American College of Cardiology Committee for the Redefinition of Myocardial Infarction. J Am Coll Cardiol 2000;36:959-969.

18. Obesity: Preventing and managing the global epidemic. Report of a WHO Consultation. Ginebra: WHO; 2000. WHO Technical Report Series.

19. Grayston JT, Wang SP, Kuo CC, Campbell LA. Current knowledge on Chlamydia pneumoniae, strain TWAR, an important cause of pneumonia and other acute respiratory diseases. Eur J Clin Microbiol Infect Dis 1989;8:191-202.

20. Mendall MA, Carrington D, Strachan D, Patel P, Molineaux N, Levi J et al. Chlamydia pneumoniae: Risk factors for seropositivity and association with coronary heart disease. J Infect 1995;30:121-128.

21. Patel P, Mendall MA, Carrington D, Strachan DP, Leatham E, Molineaux N et al. Association of Helicobacter pylori and Chlamydia pneumoniae infections with coronary heart disease and cardiovascular risk factors. BMJ 1995;311:711-714.

22. Mizooka M, Ishikawa S. JMS Cohort Study Group. Prevalence of Chlamydia pneumoniae in Japanese rural districts; association of smoking and physical activity with Chlamydia pneumoniae seropositivity. Intern Med 2003;42: 960-966.

23. Koh WP, Taylor MB, Chew SK, Phoon MC, Kang KL, Chow VT. Chlamydia pneumoniae IgG seropositivity and clinical history of ischemic heart disease in Singapore. J Microbiol Immunol Infect 2003;36:169-174.

24. Buja LM, Willerson JT. The role of coronary artery lesions in ischemic heart disease: Insights from recent clinicopathologic, coronary arteriographic, and experimental studies. Human Pathol 1987;18:451-461.

25. Kuo CC, Shor A, Campbell LA, Fukushi H, Patton DL, Grayston JT. Demonstration of Chlamydia benefit from antibiotic treatment concerning embolus pneumoniae in arteriosclerotic lesions of coronary arteries. J Infect Dis 1993;167: 841–849.

26. Campbell LA, O’Brien ER, Cappuccio AL, Kuo CC, Wang SP, Stewart D et al. Detection of Chlamydia pneumoniae TWAR in human coronary atherectomy tissue. J Infect Dis 1995;172: 585–588.

27. Wald NJ, Law MR, Morris JK, Zhou X, Wong Y, Ward ME. Chlamydia pneumoniae infection and mortality from ischaemic heart disease: Results from a large prospective study. BMJ 2000;321: 204-207.

28. Siscovick DS, Schwartz SM, Corey L, Grayston JT, Ashley R, Wang SP. Chlamydia pneumoniae, herpes simplex virus type 1, and cytomegalovirus and incident myocardial infarction and coronary heart disease death in older adults: The Cardiovascular