既往感染肺炎衣原体与急性或慢性冠状动脉疾病之间无关联。

Lack of association between prior infection with Chlamydia pneumoniae and acute or chronic coronary artery disease.

作者信息

Altman R, Rouvier J, Scazziota A, Absi R S, Gonzalez C

机构信息

Centro de Trombosis de Buenos Aires, Argentina.

出版信息

Clin Cardiol. 1999 Feb;22(2):85-90. doi: 10.1002/clc.4960220206.

DOI:10.1002/clc.4960220206

PMID:10068844

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6655370/

Abstract

BACKGROUND

Higher than normal serologic titers and the detection of bacteria within atheroma have suggested an association between Chlamydia pneumoniae (C. pneumoniae) infection and coronary heart disease (CHD), but the relationship has not been well established.

HYPOTHESIS

The study was designed to establish a lack of relationship between chronic C. pneumoniae infection and CHD.

METHODS

Chlamydia-specific IgG-antibody was assayed using an indirect immunofluorescence test in the serum of 159 patients with severe arterial disease and 203 patients with a heart valve prostheses and no demonstrable CHD. Fatal and nonfatal vascular events and systemic thromboembolism were recorded over a 2-year period.

RESULTS

In the arterial group 107 patients (67.3%) and in the valvular group 120/203 (59.1%) were positive for C. pneumoniae antibody. The number of patients with fatal or nonfatal vascular events (double end point) in the arterial and valvular groups was 23 and 2, respectively (p < .0001). Triple end points (fatal plus nonfatal vascular events plus thromboembolism) were also more frequent in the arterial group (p < 0.002). The prevalence of chlamydia antibody positivity was the same in the arterial and valvular groups, and the occurrence of clinical events was also the same for chlamydia-positive (227 patients) as for chlamydia-negative (135 patients). After adjustment for confounding variables, only arterial disease was a predictive factor for double (OR 17.0; 95% CI 3.94-73.3) or triple (OR 3.12; 95% CI 1.56-6.25) end points.

CONCLUSION

We find C. pneumoniae chronic infection not to be an independent risk factor for acute or chronic arterial disease.

摘要

背景

血清学滴度高于正常水平以及在动脉粥样硬化斑块内检测到细菌提示肺炎衣原体（C. pneumoniae）感染与冠心病（CHD）之间存在关联，但这种关系尚未完全确立。

假说

本研究旨在确定慢性肺炎衣原体感染与冠心病之间不存在关联。

方法

采用间接免疫荧光试验检测159例严重动脉疾病患者和203例心脏瓣膜置换且无明显冠心病患者血清中的衣原体特异性IgG抗体。记录2年期间的致命和非致命血管事件及全身性血栓栓塞情况。

结果

动脉疾病组107例患者（67.3%）以及心脏瓣膜置换组120/203例患者（59.1%）的肺炎衣原体抗体呈阳性。动脉疾病组和心脏瓣膜置换组中发生致命或非致命血管事件（双终点）的患者数量分别为23例和2例（p <.0001）。动脉疾病组的三终点事件（致命加非致命血管事件加血栓栓塞）也更常见（p < 0.002）。动脉疾病组和心脏瓣膜置换组中衣原体抗体阳性的患病率相同，衣原体阳性患者（227例）和衣原体阴性患者（135例）的临床事件发生率也相同。在对混杂变量进行校正后，只有动脉疾病是双终点（OR 17.0；95% CI 3.94 - 73.3）或三终点（OR 3.12；95% CI 1.56 - 6.25）事件的预测因素。