Seropositivity against Chlamydia pneumoniae in patients with coronary atherosclerosis.
BACKGROUND
Results of therapy in patients with unstable coronary syndromes with antibiotics directed against Chlamydia pneumoniae have been variable, perhaps due to the heterogeneity of patients in these trials.


OBJECTIVE
The aim of the present study was to correlate the severity of coronary artery disease (CAD) with seropositivity against C. pneumoniae prospectively.


METHODS
We measured the frequency of seropositivity (IgG levels > or = 1/64 and IgA levels > or = 1/16 against Chlamydia pneumoniae) in 110 patients with CAD and in 49 controls.


RESULTS
As expected, traditional CAD risk factors were seen more often in patients with CAD than in controls. Mean values of total cholesterol (184 +/- 52 and 166 +/- 44 mg/dl, respectively) and triglyceride (143 +/- 60 and 112 +/- 63 mg/dl, respectively) in serum were significantly higher in patients with CAD than in controls (both p < 0.04). There were no significant differences between the two groups in serum high-density lipoprotein cholesterol (34 +/- 13 and 32 +/- 14 mg/dl, respectively) and lipoprotein (a) (Lp(a):241 +/- 247 and 223 +/- 263 mg/l, respectively) levels. The rate of IgG seropositivity was 52% (28/54) in patients with stable CAD, 41% (23/56) in patients with unstable CAD, and 35% in controls (p = NS). The rate of IgA seropositivity was 25% (14/54) in patients with stable CAD, 12% (6/49) in patients with unstable angina, and 12% (6/49) in controls (all p = NS).


CONCLUSIONS
Only a small percentage of patients with CAD demonstrate seropositivity against Chlamydia pneumoniae. Antibiotic therapy in these selected patients, but not in the remaining patients, may be considered rational. These considerations may underlie the failure to see consistent benefits of antibiotic therapy in patients with CAD.
Romeo
F
F
Department of Cardiology, University of Rome Tor Vergata, Italy.
Martuscelli
E
E
Chirieolo
G
G
Cerabino
L M
LM
Ericson
K
K
Saldeen
T G
TG
Mehta
J L
JL
D000704:Analysis of Variance; D000787:Angina Pectoris / Q000175:diagnosis / Q000382:microbiology; D000789:Angina, Unstable / Q000175:diagnosis / Q000382:microbiology; D002690:Chlamydia Infections / Q000175:diagnosis* / Q000276:immunology; D016993:Chlamydophila pneumoniae / Q000276:immunology*; D003324:Coronary Artery Disease / Q000175:diagnosis* / Q000382:microbiology*; D005260:Female; D006801:Humans; D007070:Immunoglobulin A / Q000097:blood*; D007074:Immunoglobulin G / Q000097:blood*; D008297:Male; D011336:Probability; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D012698:Serologic Tests; D012720:Severity of Illness Index
D007070:Immunoglobulin A; D007074:Immunoglobulin G