ASSOCIATION OF CHLAMYDIA PNEUMONIAE AND INCREASED C-REACTIVE PROTEIN LEVELS IN MULTIVESSEL CORONARY ARTERY DISEASE
M.K.C. Ng*, V. Sintchenko, W. Meldrum-Hanna, M.P. Skinner, D.L. Ross, L. Gilbert.
Departments of Cardiology and Microbiology, Westmead Hospital, Sydney, New South Wales.
Atherosclerosis has many features of a chronic inflammatory disease and increased levels of acute phase proteins, e.g. C-reactive protein (CRP) have been reported to predict the risk of myocardial infarction. The cause of inflammation is unknown but may include infection. We sought to evaluate the relationship between serological evidence of Chlamydia pneumoniae (CP) infection and CRP levels in patients with multivessel coronary artery disease.
Methods: In 17 consecutive patients undergoing elective coronary artery bypass grafting and coronary endarterectomy and participating in a pilot clinico-pathological study evaluating intracoronary Chlamydia pneumoniae infection, Chlamydiapneumoniae IgG antibody titres and levels of C-reactive protein were determined prior to surgery. Serum samples were assayed for IgG antibody to CP using a microimmunofluoresence test. A threshold titre of at least 1:32 was chosen to indicate seropositivity.
Results: Fourteen (83.4% patients were seropositive for CP. A significant positive association was observed between CP IgG titre and CRP level (rank correlation coefficient 0.50, p = 0.04). Of those patients with CP IgG titre >=1:256, three of eight had C-reactive protein levels of > 10mg/L compared with none of those whose titres were < 1:256 (corrected Chi squared p = 0.05).
Conclusions: Chlamydia pneumoniae seropositivity is common in multivessel coronary artery disease. There is a significant association between high Chlamydia pneumoniae IgG antibody titres and increased C-reactive protein levels. Chlamydiapneumoniae infection may contribute to inflammation and play a role in progression of coronary artery disease.
