Association of Chlamydia pneumoniae antibody with the cholesterol-lowering effect of statins.
To investigate the association between Chlamydia pneumoniae (C. pneumoniae) infection and atherosclerosis, we compared the effect of lipid-lowering drugs on carotid intima-media thickness (IMT) between patients who were positive and negative for C. pneumoniae antibodies. A total of 165 asymptomatic hypercholesterolemic patients were randomized to probucol (500 mg per day, n = 82) or pravastatin (10 mg per day, n = 83) and followed for 2 years. The 2-year change of IMT in the common carotid artery was the primary endpoint, while mean IMT change and major cardiovascular events were secondary endpoints. C. pneumoniae antibodies (IgA and IgG) were measured by enzyme-linked immunosorbent assay. The 50 patients without C. pneumoniae antibodies showed significant reduction of IMT progression (-19%), while no significant change of IMT was noted in the 115 antibody-positive patients (-6%). Significant inverse associations were found between the reduction of IMT progression and the C. pneumoniae IgA- and IgG-antibody index (P < 0.01 and 0.01, respectively). No significant differences in the reduction of serum total-cholesterol and LDL-cholesterol were found between antibody-positive and -negative patients. There was no significant difference of efficacy between probucol and pravastatin. These observations suggest that C. pneumoniae infection reduces the effect of lipid-lowering therapy on carotid atherosclerosis and that this organism may play a role in the progression of atherosclerosis.
Sawayama
Yasunori
Y
Department of General Medicine, Kyushu University Hospital, Higashi-ku, Fukuoka 812-8582, Japan.
Tatsukawa
Masafumi
M
Okada
Kyoko
K
Maeda
Naoyasu
N
Shimizu
Chie
C
Kikuchi
Kensuke
K
Hayashi
Jun
J
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000792:Angiography; D000907:Antibodies, Bacterial / Q000187:drug effects / Q000276:immunology*; D015153:Blotting, Western; D002340:Carotid Artery Diseases / Q000150:complications* / Q000000981:diagnostic imaging / Q000188:drug therapy*; D023521:Chlamydophila Infections / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D016993:Chlamydophila pneumoniae / Q000276:immunology*; D018450:Disease Progression; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000008:administration & dosage*; D007070:Immunoglobulin A / Q000276:immunology; D007074:Immunoglobulin G / Q000276:immunology; D008077:Lipoproteins, LDL / Q000097:blood; D008297:Male; D008875:Middle Aged; D017035:Pravastatin / Q000008:administration & dosage; D011341:Probucol / Q000008:administration & dosage; D018570:Risk Assessment; D012720:Severity of Illness Index; D016896:Treatment Outcome
D000907:Antibodies, Bacterial; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D007070:Immunoglobulin A; D007074:Immunoglobulin G; D008077:Lipoproteins, LDL; D017035:Pravastatin; D011341:Probucol