Previous exposure to Chlamydia pneumoniae, Helicobacter pylori and other infections in Canadian patients with ischemic heart disease.
OBJECTIVE
Previous exposures to Chlamydia pneumoniae (CP), Helicobacter pylori (HP) or cytomegalovirus (CMV) have been associated with atherosclerotic heart disease. These associations were studied in Canadian patients, and the exposure to five infections measured.


METHODS
Case-control study.


METHODS
In the coronary care units (Hamilton General site, Henderson General site, McMaster University Medical Centre site of the Hamilton Health Sciences Corporation and St Joseph's Hospital) and from the regional angiography suite (Hamilton General site), Hamilton, Ontario.


METHODS
One hundred seven consecutive patients presenting with myocardial infarction or unstable angina (coronary care unit patients), or with previous angina or myocardial infarction (angiography suite patients), were compared with 107 family practice or outpatient clinic control subjects.


METHODS
Cardiovascular risk factors were measured, as was serology for CP, HP, CMV, adenovirus and hepatitis A virus. Statistical analysis was by logistic regression, adjusted for age and sex.


RESULTS
Exposure to CP was more frequent in patients than in control subjects (85.4% versus 70.3%, adjusted odds ratio [OR] 2.3, 95% CI 1.1 to 5.1, P=0.03). Dividing CP immunoglobulin G absorbance into quarters, with the lowest quarter as the reference group, the adjusted ORs were 2.8, 3.0 and 4.3, respectively, for the second, third and fourth quarters (P=0.001 for trend). The seroprevalences of HP (61.7%), CMV (64.0%), adenovirus (75.6%) and hepatitis A virus (59.2%) were high, with no association with disease.


CONCLUSIONS
An association was found between heart disease and previous exposure to CP, with a stepwise increase in ORs at higher antibody levels, whereas no association was found with HP, CMV or other infections. A prospective validation of this association is needed.
St Joseph's Hospital, Hamilton, Canada.
M
M
Smieja
L
L
Cronin
M
M
Levine
C H
CH
Goldsmith
S
S
Yusuf
J B
JB
Mahony
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000907:Antibodies, Bacterial / Q000032:analysis*; D000914:Antibodies, Viral / Q000032:analysis; D023521:Chlamydophila Infections / Q000150:complications* / Q000453:epidemiology / Q000382:microbiology; D016993:Chlamydophila pneumoniae / Q000276:immunology*; D017023:Coronary Angiography; D003587:Cytomegalovirus / Q000276:immunology; D003586:Cytomegalovirus Infections / Q000150:complications / Q000453:epidemiology / Q000821:virology; D005260:Female; D016481:Helicobacter Infections / Q000150:complications* / Q000453:epidemiology / Q000382:microbiology; D016480:Helicobacter pylori / Q000276:immunology*; D006801:Humans; D007074:Immunoglobulin G / Q000276:immunology; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000209:etiology*; D009864:Ontario / Q000453:epidemiology; D015995:Prevalence; D012189:Retrospective Studies; D012307:Risk Factors
D000907:Antibodies, Bacterial; D000914:Antibodies, Viral; D007074:Immunoglobulin G