title: Serum chlamydial lipopolysaccharide as a prognostic factor for a new cardiovascular event.
abstract: BACKGROUND
  Infections caused by Chlamydia pneumoniae are considered to participate in inflammatory processes leading to coronary artery disease. After a primary infection, the bacteria remain dormant intracellularly causing a chronic inflammatory stimulus.
  
  
  METHODS
  Blood samples were obtained from 235 patients with acute myocardial infarction (AMI) and 108 patients with unstable angina pectoris (UA). We evaluated the prognostic significance of bacterial and viral antibody titers, serum troponin T, C-reactive protein, and chlamydial lipopolysaccharide (cLPS) concentrations during acute coronary syndrome of patients with AMI and UA for cardiovascular death and new UA and AMI that required hospital care during a 6-year follow-up.
  
  
  RESULTS
  Serum cLPS levels correlated with C-reactive protein and serum troponin T concentrations during acute coronary events. Patients with AMI had significantly higher serum concentration of cLPS compared with patients with UA. Enterovirus antibody titers and cholesterol-lowering therapy at admission of the index event were negatively correlated with cLPS concentration (r = -.198, P = .0003 and r = -.26, P = .019, respectively). The presence of circulating cLPS was associated with a hazard ratio of 2.04 for a new cardiovascular event during the follow-up period (P = .006). The area under the curve in the receiver operating graph was .572.
  
  
  CONCLUSIONS
  cLPS is evidently liberated from the infected atherosclerotic tissue during an acute coronary event. Our study supports the view that inflammation caused by C. pneumoniae infection is an important but as yet poorly understood factor in the development of atherosclerosis and may play a role in acute vascular events.
authors.affiliation: Pediatric Cardiology, University Hospital of Lund, Getingevägen 4, Lund SE-221 85, Sweden.
authors.forename: Erkki
authors.initials: E
authors.lastname: Pesonen
authors.forename: Terttu
authors.initials: T
authors.lastname: Tiirola
authors.forename: Eeva
authors.initials: E
authors.lastname: Andsberg
authors.forename: Matti
authors.initials: M
authors.lastname: Jauhiainen
authors.forename: Matti
authors.initials: M
authors.lastname: Paldanius
authors.forename: Kenneth
authors.initials: K
authors.lastname: Persson
authors.forename: Pekka
authors.initials: P
authors.lastname: Saikku
authors.forename: Seppo
authors.initials: S
authors.lastname: Sarna
authors.forename: Hans
authors.initials: H
authors.lastname: Ohlin
authors.forename: Maija
authors.initials: M
authors.lastname: Leinonen
mesh_terms: D000789:Angina, Unstable / Q000097:blood / Q000209:etiology* / Q000382:microbiology; D002097:C-Reactive Protein; D002690:Chlamydia Infections / Q000150:complications* / Q000382:microbiology; D016993:Chlamydophila pneumoniae / Q000302:isolation & purification*; D016001:Confidence Intervals; D003324:Coronary Artery Disease / Q000097:blood / Q000209:etiology / Q000382:microbiology; D018450:Disease Progression; D006801:Humans; D007249:Inflammation / Q000209:etiology* / Q000382:microbiology; D008070:Lipopolysaccharides / Q000032:analysis / Q000097:blood*; D011379:Prognosis; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012307:Risk Factors
chemical_list: D008070:Lipopolysaccharides; D002097:C-Reactive Protein