FAILURE TO
DETECT CHLAMYDIA NEUMONIAE N CORONARY ATHEROMAS OF AUSTRALIAN PATIENTS
UNDERGING CORONARY ARTER BYPASS GRAFTING. M.K.C. Ng*,
GV. Sintchenko, W. Meldrum-Hanna, M.P. Skinner, D. L. Ross and G.L. Gilbert. Department of
Cardiology and Centre for Infectious Diseases and Microbiology Laboratory
Services, Westmead Hospital, Sydney, NSW. The
association between coronary artery disease (CAD) and Chlamydia Penumoniae
(Cp) infection remains under debate. A number of pathological studies from
different populations have produced conflicting data regarding intracoronary
presence of Cp, giving rise to the concept of regional differences in patterns
of Cp infection. There is no Australian data on intracoronary Cp prevalence. We
sought to investigate the presence of Cp in coronary artery and venous bypass
graft atheroma obtained at coronary artery bypass grafting (CABG) for
multi-vessel CAD. Methods: In 30
consecutive patients undergoing elective CAB and coronary endarterectomy,
segments of atherosclerotic native coronary artery were obtained
intraoperatively. Where possible, segments of diseased vein graft and
macroscopically normal left internal mammary artery were also collected. Each
specimen was examined for Cp by cell culture and polymerase chain reaction (PCR)
Serum samples were assayed for IgG and IgA antibody to Cp using a
microimmunofluorescence and enzyme immunoassay respectively. Result: We examined 33
atherosclerotic native coronary artery segments, 13 diseased vein graft
specimens and 10 segments of internal mammary artery. None of them had evidence
for Cp presence by PCR or cell culture. Twenty-six (87%) and the (33%) patients
were seropositive for IgG and IgA to Cp respectively. Conclusion:In a
population of Australian patients with multi-vessel CAB no pathological
evidence of intracoronary Cp infection has been found despite a high rate of Cp
seropositive. Our findings support the possibility of regional variations in
patters of Cp infections.
