Severity of carotid atherosclerosis unrelated to Chlamydia pneumoniae infection in acute ischemic stroke patients: a clinicopathological study.
BACKGROUND
Both clinical and pathological alterations of the carotid arteries were correlated with Chlamydia pneumoniae infection in 67 acute ischemic stroke patients with severe neurological symptoms.


METHODS
In the clinical study, intima-media thickness (IMT) of the common carotid arteries was determined in vivo by B-mode ultrasound measurement and C. pneumoniae-specific IgG and IgA responses were detected. In the pathological study, the absolute wall thickness of the common, internal and external carotid arteries was measured postmortem in specimens obtained at the autopsy of patients who died due to complications of acute stroke. In the atherosclerotic plaques of the autopsy specimens, C. pneumoniae genomic DNA was detected by polymerase chain reaction amplification.


RESULTS
The Spearman's rho correlation coefficient of IMT with the average wall thickness of the common, internal and external carotid arteries was 0.51 (p = 0.002), 0.34 (p = 0.052) and 0.58 (p < 0.001), respectively. Anti-C. pneumoniae IgG and IgA antibodies were detected in 43 (73%) and 29 (49%) patients, but neither antibody marker correlated with IMT (median: 0.91 mm in IgG positives vs. 0.90 mm in IgG negatives, p = 0.86; 0.88 mm in IgA positives vs. 0.90 mm in IgA negatives, p = 0.53). The presence of C. pneumoniae DNA was detected in the carotid plaques of 21 (54%) of the 39 tested patients, independently of either IMT values or the average wall thickness of all carotid arteries.


CONCLUSIONS
In acute ischemic stroke patients, C. pneumoniae infection was frequently detected in the arteriosclerotic plaques of the carotid arteries but it did not correlate with the severity of carotid arteriosclerosis.
Kónya
József
J
Department of Medical Microbiology, Medical and Health Science Center, University of Debrecen, Debrecen, Hungary. konya@dote.hu
Molnár
Sándor
S
Magyar
Mária T
MT
Szekeres
Csilla C
CC
Kerényi
Levente
L
Csiba
László
L
D000368:Aged; D000369:Aged, 80 and over; D001344:Autopsy; D002545:Brain Ischemia / Q000150:complications* / Q000382:microbiology / Q000473:pathology; D002340:Carotid Artery Diseases / Q000382:microbiology* / Q000473:pathology*; D017536:Carotid Artery, Common; D016993:Chlamydophila pneumoniae / Q000302:isolation & purification*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012720:Severity of Illness Index; D020521:Stroke / Q000150:complications* / Q000382:microbiology / Q000473:pathology; D017539:Tunica Intima / Q000473:pathology; D017540:Tunica Media / Q000473:pathology