Chlamydia pneumoniae and atherosclerosis following carotid endarterectomy.
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.
Jahromi
Babak S
BS
Department of Neurosurgery, St. Michael's Hospital, University of Toronto, Toronto, ON, Canada.
Hill
Michael D
MD
Holmes
Kate
K
Hutchison
Stuart
S
Tucker
William S
WS
Chiu
Brian
B
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