[Inflammation and infection in stable coronary disease and acute coronary syndrome].
OBJECTIVE
To study whether inflammation and infection are related to coronary artery disease.


METHODS
Sixty patients (44 males, mean age 62 +/- 13 years) with acute coronary syndrome and 40 with stable coronary artery disease (31 males, age 64 +/- 10 years) and a control group of 40 individuals (34 males, 53 +/- 5 years) were analyzed. IgG against Chlamydia pneumoniae, Cytomegalovirus and Helicobacter pylori plus C-reactive protein were assessed in all serum samples. In addition, IgM against C. pneumoniae and Cytomegalovirus on admission and C-reactive protein one month later were measured in acute patients.


RESULTS
No IgM seropositivity was observed. A high prevalence of IgG seropositivity with no significant differences among the groups was found: C. pneumoniae: acute group 44 (73%), stable group 29 (73%) and control group 25 (63%); Cytomegalovirus: 55 (92%), 37 (92%) and 38 (95%), respectively; and H. pylori, 43 (72%), 32 (80%) and 34 (85%) respectively. There was a high rate of positive C-reactive protein in the acute group: 48 (80%) vs 10 (25%) the stable group and 0% the control group (p < 0.001). C-reactive protein levels were higher in Q-wave infarction than in unstable angina/ non-Q-wave infarction (median 22.65 vs 7.69, p < 0.001). One month later, C-reactive protein levels decreased (median 22.65 vs 3.38, p < 0.001), but were still positive in 40%.


CONCLUSIONS
These data suggest that inflammation is detected by the commonly used methods in clinic practice in acute coronary syndromes and to a lesser extent in stable coronary artery disease. It seems that different mechanisms other than infection account for this inflammatory response, at least this being so when infection is assessed by serology. Serology does not appear to be an adequate method to determine the possible relationship among coronary syndromes, infection and inflammation.
Departamentos de Cardiología, ICICOR de la Universidad, Valladolid. jbgarcia@scisquemica.org
J
J
Bermejo García
P
P
Martínez Martínez
J F
JF
Martín Rodríguez
M
M
de la Torre Carpente
R
R
Bustamante Bustamante
A B
AB
Guerrero Peral
R
R
Ortiz de Lejarazu
J M
JM
Eiros Bouza
S
S
Blanco García
F
F
Fernández-Avilés
D023521:Chlamydophila Infections / Q000097:blood / Q000150:complications*; D016993:Chlamydophila pneumoniae; D003327:Coronary Disease / Q000097:blood / Q000150:complications* / Q000276:immunology*; D003586:Cytomegalovirus Infections / Q000097:blood / Q000150:complications*; D005260:Female; D016481:Helicobacter Infections / Q000097:blood / Q000150:complications*; D016480:Helicobacter pylori; D006801:Humans; D007075:Immunoglobulin M / Q000097:blood; D007249:Inflammation / Q000097:blood / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D013577:Syndrome
D007075:Immunoglobulin M