title: Chlamydia pneumoniae and atherosclerosis following carotid endarterectomy.
abstract: BACKGROUND
  Seroepidemiological studies have shown an association between raised antibody titres against Chlamydia pneumoniae, and carotid atherosclerosis or stroke. However, direct evidence for a causal link between arterial infection with C. pneumoniae and carotid disease remains weak. We hypothesized that long-term follow-up of patients with pathologically-proven arterial C. pneumoniae infection might provide further insight into the role of C. pneumoniae in carotid atherosclerosis.
  
  
  METHODS
  We followed a cohort of 70 carotid endarterectomy patients for ipsilateral restenosis, contralateral progression, and all-cause mortality (four year median follow-up period). All patients had presence or absence of C. pneumoniae in their carotid plaques documented by immunohistochemistry after endarterectomy. A survival function was generated and the log-rank test was used to assess the difference in survival between subjects with and without documented chlamydial infection in their plaque.
  
  
  RESULTS
  Baseline demographic and cardiovascular risk factors were similar between the two groups, and survival analysis demonstrated no difference (p>0.05) in all-cause mortality, or all-cause mortality combined with restenosis and progression.
  
  
  CONCLUSIONS
  Our data finds no causal role for C. pneumoniae in restenosis or progression of carotid disease or mortality in this patient population with advanced carotid atherosclerosis.
authors.affiliation: Department of Neurosurgery, St. Michael's Hospital, University of Toronto, Toronto, ON, Canada.
authors.forename: Babak S
authors.initials: BS
authors.lastname: Jahromi
authors.forename: Michael D
authors.initials: MD
authors.lastname: Hill
authors.forename: Kate
authors.initials: K
authors.lastname: Holmes
authors.forename: Stuart
authors.initials: S
authors.lastname: Hutchison
authors.forename: William S
authors.initials: WS
authors.lastname: Tucker
authors.forename: Brian
authors.initials: B
authors.lastname: Chiu
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002340:Carotid Artery Diseases / Q000382:microbiology* / Q000401:mortality / Q000473:pathology*; D002690:Chlamydia Infections / Q000382:microbiology* / Q000401:mortality / Q000473:pathology*; D016993:Chlamydophila pneumoniae / Q000302:isolation & purification*; D015331:Cohort Studies; D016894:Endarterectomy, Carotid / Q000009:adverse effects* / Q000706:statistics & numerical data; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests