title: Close association of Chlamydia pneumoniae IgA seropositivity by ELISA with the presence of coronary artery stenosis in haemodialysis patients.
abstract: BACKGROUND
  Traditional risk factors of cardiovascular disease do not fully explain the accelerated atherosclerosis present in patients with end-stage renal disease (ESRD). The goal of this study was to identify the association of clinical and laboratory factors including seropositivity for Chlamydia pneumoniae determined by a specific enzyme-linked immunosorbent assay (ELISA) with the presence of coronary artery disease identified by coronary angiography in ESRD patients.
  
  
  METHODS
  We prospectively enrolled 161 consecutive ESRD patients undergoing haemodialysis for >6 months (106 men, 55 women; mean age 63.1+/-10.2 years; mean dialysis duration 91.3+/-90.1 months). All patients underwent coronary angiography within 1 week after blood sampling. The associations of coronary artery disease with clinical parameters including C. pneumoniae IgA and IgG seropositivity were analysed using multiple logistic regression models.
  
  
  RESULTS
  Coronary stenosis >50% was found in 102 of 161 haemodialysis patients (63.4%). Of the 102 patients, 75.5% were asymptomatic. Seropositivity for C. pneumoniae IgA was found in patients with coronary stenosis (77 out of 102, 75.5%) more frequently (P<0.001) than in patients without coronary stenosis (10 out of 59, 16.9%). Seropositivity for C. pneumoniae IgA but not IgG was strongly associated with the presence of coronary stenosis in multiple logistic regression analysis (odds ratio, 18.440; 95% confidence interval, 7.500-45.337), independently of the Framingham coronary risk factors, factors peculiar to ESRD or serum C-reactive protein levels.
  
  
  CONCLUSIONS
  C. pneumoniae IgA seropositivity determined by ELISA is an independent laboratory factor indicating the presence of coronary artery stenosis in ESRD patients undergoing maintenance haemodialysis.
authors.affiliation: Cardiovascular Division, Toujinkai Hospital, 16 Negoro, Momoyama-cho, Fushimi-ku, Kyoto, 612-8024 Japan. mnishimura@tea.ocn.ne.jp
authors.forename: Masato
authors.initials: M
authors.lastname: Nishimura
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Hashimoto
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Kobayashi
authors.forename: Toyofumi
authors.initials: T
authors.lastname: Fukuda
authors.forename: Koji
authors.initials: K
authors.lastname: Okino
authors.forename: Noriyuki
authors.initials: N
authors.lastname: Yamamoto
authors.forename: Chikako
authors.initials: C
authors.lastname: Mashida
authors.forename: Kiyotaka
authors.initials: K
authors.lastname: Kawagoe
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Fujita
authors.forename: Naoto
authors.initials: N
authors.lastname: Inoue
authors.forename: Hakuo
authors.initials: H
authors.lastname: Takahashi
authors.forename: Toshihiko
authors.initials: T
authors.lastname: Ono
mesh_terms: D000368:Aged; D000907:Antibodies, Bacterial / Q000097:blood*; D023521:Chlamydophila Infections / Q000276:immunology; D016993:Chlamydophila pneumoniae / Q000276:immunology; D023921:Coronary Stenosis / Q000097:blood / Q000453:epidemiology* / Q000276:immunology / Q000382:microbiology; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D007070:Immunoglobulin A / Q000097:blood*; D007676:Kidney Failure, Chronic / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D006435:Renal Dialysis / Q000009:adverse effects
chemical_list: D000907:Antibodies, Bacterial; D007070:Immunoglobulin A