title: Chlamydia pneumoniae infection and cerebrovascular disease: a systematic review and meta-analysis.
abstract: BACKGROUND
  A wealth of published studies have been published on association between Chlamydia pneumoniae (C.pneumoniae) infection and cerebrovascular (CV) disease, but the results were inconsistent. This meta-analysis provides a systematic review of the available evidence from all serological and pathological studies of CV disease and C.pneumoniae.
  
  
  METHODS
  A comprehensive research was conducted of MEDLINE, EMBASE, CNKI, WanFang technological periodical database and reference lists of articles to identify eligible case-control and cohort studies. Odds radio (OR) was calculated for each study outcome. Random effect model was used as pooling method and publication bias was estimated for the results.
  
  
  RESULTS
  Fifty-two published studies that met criteria were selected. In case control studies, an association between C.pneumoniae infection and CV disease was revealed by serum specific IgG (OR, 1.61; 95% CI: 1.34 to 1.94), serum IgA (OR, 2.33; 95% CI: 1.76 to 3.08) and PCR technique of C.pneumoniae in peripheral blood cells (OR, 1.90; 95% CI: 1.17 to 3.07). No significant association was found in serum anti-C.pneumonae IgM seropositivity or in-situ-detection of C.pneumoniae in arterial biopsies with CV disease. Subgroup analysis by available studies suggested that C.pneumoniae may paly a role in atherosclerotic stroke, but be less significant in stroke of cardioembolism or other etiologies.
  
  
  CONCLUSIONS
  Association between C.pneumoniae infection and CV disease depends on the analytical method adopted, which seems stronger with stroke due to large artery atherosclerosis. Establishing a causal relationship between C.peumoniae infection and CV disease will require more prospective studies with combination of techniques and stratified by etiological subtypes.
authors.affiliation: Department of Neurology, Affiliated Qianfoshan Hospital of Shandong University, 66 Jingshi Road, Jinan, Shandong province 250014, China. zhumeijia1818@gmail.com.
authors.forename: Juan
authors.initials: J
authors.lastname: Chen
authors.forename: Meijia
authors.initials: M
authors.lastname: Zhu
authors.forename: Gaoting
authors.initials: G
authors.lastname: Ma
authors.forename: Zhangning
authors.initials: Z
authors.lastname: Zhao
authors.forename: Zhongwen
authors.initials: Z
authors.lastname: Sun
mesh_terms: D002561:Cerebrovascular Disorders / Q000209:etiology* / Q000382:microbiology; D023521:Chlamydophila Infections / Q000150:complications*; D016993:Chlamydophila pneumoniae / Q000235:genetics / Q000472:pathogenicity*; D016206:Databases, Bibliographic / Q000706:statistics & numerical data; D006801:Humans