Impact of Chlamydia pneumoniae infection on survival rate after heart transplantation.
BACKGROUND
As Chlamydia pneumoniae (Cp), a common cause of respiratory infection, is of vasotropic character, chronic infection may be associated with the development of coronary disease, although there have been few reports on the impact of Cp infection on the post-orthotopic heart transplantation (OHT) survival rate.


METHODS
A total of 41 patients (4 females) were followed up for one year after OHT. Serology investigations for IgM, IgG and IgA antibodies against Cp were performed using the enzyme immunoassay (EIA) method. Univariate and multivariate analyses were carried out with respect to IgA, IgG, gender and type of cardiomyopathy. The IgA-IgG joint effect was also studied.


RESULTS
The one-year survival rate was reported for patients with IgA < 8 EIU to be 72.2%, whereas those with IgA >or= 8 EIU accounted for only 43.5% (Kaplan-Meier analysis, p = 0.0548). In multivariate analysis IgA /IgG status proved to be a highly significant factor in survival. IgA positive outcome combined with IgG negative outcome showed that the relative risk of death equaled 12.08 versus other combinations of IgA/IgG status. In the Cox multivariate model ischemic cardiomyopathy showed a relative risk of 2.79 (p=0.0594), although it was not significant in univariate


CONCLUSIONS
Chronic Cp infection, as expressed through a high IgA level, seems to have adverse impact on the survival rate in one-year follow-up after OHT. IgA titers against Cp in heart transplant recipients should therefore be assessed, as the high values might be a predictive risk factor within the first post-operative year.
Pieniazek
Piotr
P
Department of Cardiac and Vascular Disease, Institute of Cardiology, Jagiellonian University School of Medicine, Cracow, Poland. kardio@kki.krakow.pl
Stepień
Ewa
E
Sadowski
Jerzy
J
Przewłocki
Tadeusz
T
Sokołowski
Andrzej
A
Podolec
Piotr
P
Kapelak
Bogusław
B
Przybyłowski
Piotr
P
Kadzielski
Andrzej
A
Tracz
Wiesława
W
D000328:Adult; D000368:Aged; D009202:Cardiomyopathies / Q000150:complications / Q000601:surgery*; D002690:Chlamydia Infections / Q000150:complications*; D016993:Chlamydophila pneumoniae / Q000276:immunology; D002908:Chronic Disease; D005260:Female; D005500:Follow-Up Studies; D016027:Heart Transplantation / Q000401:mortality*; D006801:Humans; D007070:Immunoglobulin A / Q000097:blood; D007074:Immunoglobulin G / Q000097:blood; D007075:Immunoglobulin M / Q000097:blood; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D015996:Survival Rate
D007070:Immunoglobulin A; D007074:Immunoglobulin G; D007075:Immunoglobulin M