[Previous infection with Chlamydia pneumoniae and long-term prognosis in patients with acute coronary syndrome with non-ST segment elevation].
OBJECTIVE
Contradictory data exists from case-control studies and in patients with stable coronary artery disease on the association of prior exposure to Chlamydia pneumoniae and cardiovascular events. We underwent a prospective study to investigate the prognostic value of C. pneumoniae seropositivity in patients with acute coronary syndromes.


METHODS
In a prospective cohort of 259 consecutive patients (194 men and 65 women), mean age 65 (10 years) with non-ST elevation acute coronary syndromes, we measured serum levels of IgG antibodies directed against C. pneumoniae.


RESULTS
After a mean follow-up of 28 (25, 29) months, the incidence of cardiovascular death or myocardial infarction was of 15% in seropositive patients versus 13% in seronegatives at IgG titers (1:64 (p=0.58); of 14% versus 14% at IgG titers > or = 1:128 (p=0.96); and of 14% versus 15% at IgG titers (1:256 (p=0.82). The relative risks (RR, 95% CI) of these major cardiac events adjusted for possible confounding factors were 1.11 (0.52-2.40); 1.01 (0.52-1.96); and 0.94 (0.48-1.87) respectively.


CONCLUSIONS
Chlamydia pneumoniae IgG seropositivity is not associated with a higher incidence of death or myocardial infarction in patients with non-ST segment elevation acute coronary syndromes.
Sionis
Alessandro
A
Institut de Malalties Cardiovasculars, Hospital Clínic de Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer, Departamento de Medicina, Universidad de Barcelona, Barcelona, España.
Bosch
Xavier
X
Marín
José L
JL
Anguera
Ignaci
I
Hage
Marta
M
Bórquez
Emiliano
E
Verbal
Fernando
F
Vidal
Josep
J
D000368:Aged; D000789:Angina, Unstable / Q000382:microbiology* / Q000401:mortality; D000907:Antibodies, Bacterial / Q000097:blood; D023521:Chlamydophila Infections / Q000503:physiopathology*; D016993:Chlamydophila pneumoniae / Q000276:immunology*; D005260:Female; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000382:microbiology / Q000401:mortality; D011379:Prognosis; D011446:Prospective Studies
D000907:Antibodies, Bacterial; D007074:Immunoglobulin G