Korean J Med.
2000 Apr;58(4):411-419.
Chlamydia pneumoniae(Cp) infection, is that a risk factor of atherosclerosis?: On the basis
of seroepidemiologic study
- Affiliations
-
- 1Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.
- 2Department of Clinical Pathology, Yonsei University College of Medicine, Seoul, Korea.
Abstract
- BACKGROUND
Several risk factors of atherosclerosis have been known. However, many patients
have been experienced coronary heart disease without known risk factors of atherosclerosis, and it has been
suggested that some kinds of infections may be associated with atherosclerosis as risk factors. Among many
candidate infectious agents, Chlamydia pneumoniae (Cp) has been showing a positive relationship with
atherosclerosis. Therefore, we investigated massive serologic study using a ELISA for detection of Cp to
identify the relationship with atherosclerosis as a risk factor.
METHODS
Serologic tests were done in patients
who were performed coronary angiogram among patients with typical symptoms of angina and with positive results
in non- invasive test (EKG, Treadmill) from May 1997 to September 1998. Among them, patients with luminal
narrowing of more than 50% in at least one vessel were grouped into 'Case group (Group I)' and patients with
normal coronary arteries or minimal lesion were grouped into 'Positive control group(Group II)'. We also studied
healthy persons, as a 'Negative control group (Group III), who had not experienced any symptoms related with
coronary heart disease and had normal EKG findings. Serologic tests for Cp-IgG and Cp-IgA were performed by ELISA.
RESULTS
There was no statistical difference in seropositive rate between Group I and II, but seropositive rate
of Group III was statistically lower than those of Group I or II for Cp-IgG, Cp-IgA, and both, respectively.
But multivariate analysis by using logistic regression showed no statistcal differences between groups.
Subgrouping by several traditional risk factors, seropositive rate for Cp-IgG and both IgG and IgA,
was significantly different between Group I and III in patients without traditional risk factors of
atherosclerosis, such as, females, non-smokers, normotension, non-diabetes, normal cholesterol level,
and high HDL-cholesterol level. For Cp-IgA, however, the difference was observed in normotension,
non-diabetes, and in normal cholesterol level. In multivariate analysis, seropositive rate for Cp-IgG
and both IgG and IgA was significantly different between Group I and III in females and non-smokers,
but not for the Cp-IgA. CONCLUSIONS: These results suggest that Cp infection might be an independent
risk factor of atherosclerotic coronary disease, particularly in patients without traditional risk
factors of atherosclerosis. Further study with coronary tissue should be continued.