Cytomegalovirus and Chlamydia pneumoniae as predictors for adverse events and angina pectoris after percutaneous coronary intervention.
BACKGROUND
The aim of our study was to investigate the influence of prior cytomegalovirus (CMV) or Chlamydia pneumoniae (CP) infection on prognosis after percutaneous coronary intervention (PCI).


METHODS
Using the enzyme-linked immunosorbent assay technique preprocedural anti-CMV immunoglobulin G and anti-CP immunoglobulin A (CP IgA), immunoglobulin M, and immunoglobulin G antibodies were measured. Repeat anginal complaints and major adverse clinical events (MACE), including PCI, coronary artery bypass grafting, myocardial infarction, and death, were recorded at 8-month follow-up.


RESULTS
Six hundred consecutive patients were included after successful PCI. Sixty-four percent of the patients were stented. The mean age was 61.6 years, and 68.9% were male. The rate of seropositivity for CP IgA in patients with MACE as compared with patients without MACE was 50.9% versus 35.4% (P =.0276). In patients with repeat anginal complaints, CP IgA seropositivity was 41.6% versus 34.6% in patients without repeat angina (P =.1057). The negative effect of CP on prognosis was confirmed after calculating the odds ratios for MACE (1.9, 95% CI 1.1-3.3). The rates of seropositivity for anti-CMV immunoglobulin G were not significantly different between both groups, although we found an association between infectious burden and repeat angina pectoris (odds ratio 1.8, 95% CI 1.1-3.0).


CONCLUSIONS
We conclude that preprocedural seropositivity of CP IgA is a risk factor for MACE and angina pectoris after PCI. Although no such relation was found for CMV alone, the cumulative infectious burden was also related to these clinical manifestations of restenosis.
Department of Cardiology, Heart Lung Centre Utrecht, St Antonius Hospital Nieuwegein, Nieuwegein, The Netherlands. b.rahel@antonius.net
Braim M
BM
Rahel
Frank L J
FL
Visseren
Maarten-Jan
MJ
Suttorp
Thijs H W
TH
Plokker
Johannes C
JC
Kelder
Bartelt M
BM
de Jongh
Rob J A
RJ
Diepersloot
Roel P A J
RP
Verkooyen
K Paul
KP
Bouter
D000787:Angina Pectoris / Q000209:etiology; D015906:Angioplasty, Balloon, Coronary; D023521:Chlamydophila Infections / Q000150:complications*; D016993:Chlamydophila pneumoniae / Q000302:isolation & purification; D001026:Coronary Artery Bypass; D003327:Coronary Disease / Q000150:complications / Q000628:therapy*; D023903:Coronary Restenosis / Q000209:etiology*; D003587:Cytomegalovirus / Q000302:isolation & purification; D003586:Cytomegalovirus Infections / Q000150:complications*; D018572:Disease-Free Survival; D005260:Female; D005343:Fibrinolytic Agents / Q000627:therapeutic use; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000209:etiology; D011379:Prognosis; D012008:Recurrence
D005343:Fibrinolytic Agents