title: C-reactive protein, Helicobacter pylori, Chlamydia pneumoniae, cytomegalovirus and risk for myocardial infarction.
abstract: OBJECTIVE
  C-reactive protein (CRP), Chlamydia pneumonia, Helicobacter pylori, and cytomegalovirus (CMV) have each been associated with atherosclerosis. We assessed how infection and CRP related to risk for subsequent myocardial infarction (MI).
  
  
  METHODS
  Using a nested case-control design, we assessed how these factors independently and jointly affected risk for myocardial infarction (MI). Cases of first MI (N = 121) were identified from among participants in a multiphasic health check-up cohort. Controls without MI (N = 204) were matched to cases by gender, age, race, and date of serum collection. Sera collected at enrollment were tested for antibodies to infection and for CRP.
  
  
  RESULTS
  In multivariate analysis (mean follow-up of 5.1 years), CRP was associated with MI only in subjects older than 51 years (p = 0.004). Although H. pylori infection increased risk for MI, this association was modest (OR = 1.90, 95% CI = 0.97-3.71) and was not evident in non-smokers or when adjusted for education. No association between C. pneumoniae or cytomegalovirus and MI was observed, nor was the association between CRP and MI explained by these infections.
  
  
  CONCLUSIONS
  Elevated CRP is a risk factor for subsequent MI in older individuals. The relationship between Hp and MI may be due to confounding or co-linearity with socioeconomic status.
authors.affiliation: Department of Medicine, Stanford University School of Medicine, CA 94305, USA.
authors.forename: Heidi L
authors.initials: HL
authors.lastname: Witherell
authors.forename: Karen L
authors.initials: KL
authors.lastname: Smith
authors.forename: Gary D
authors.initials: GD
authors.lastname: Friedman
authors.forename: Catherine
authors.initials: C
authors.lastname: Ley
authors.forename: David H
authors.initials: DH
authors.lastname: Thom
authors.forename: Norman
authors.initials: N
authors.lastname: Orentreich
authors.forename: Joseph H
authors.initials: JH
authors.lastname: Vogelman
authors.forename: Julie
authors.initials: J
authors.lastname: Parsonnet
mesh_terms: D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D023521:Chlamydophila Infections / Q000150:complications*; D016993:Chlamydophila pneumoniae / Q000472:pathogenicity*; D003324:Coronary Artery Disease / Q000209:etiology; D003586:Cytomegalovirus Infections / Q000150:complications*; D005260:Female; D016481:Helicobacter Infections / Q000150:complications*; D016480:Helicobacter pylori / Q000472:pathogenicity*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000453:epidemiology / Q000209:etiology* / Q000382:microbiology*; D016017:Odds Ratio; D012307:Risk Factors