Ridker P M, Kundsin R B, Stampfer M J, Poulin S, Hennekens C H
Divisions of Cardiology, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
Circulation. 1999 Mar 9;99(9):1161-4. doi: 10.1161/01.cir.99.9.1161.
Chlamydia pneumoniae has been hypothesized to play a role in atherothrombosis. However, prospective data relating exposure to Chlamydia pneumoniae and risks of future myocardial infarction (MI) are sparse.
In a prospective cohort of nearly 15 000 healthy men, we measured IgG antibodies directed against Chlamydia pneumoniae in blood samples collected at baseline from 343 study participants who subsequently reported a first MI and from an equal number of age- and smoking-matched control subjects who did not report vascular disease during a 12-year follow-up period. The proportion of study subjects with IgG antibodies directed against Chlamydia increased with age and cigarette consumption. However, prevalence rates of Chlamydia IgG seropositivity were virtually identical at baseline among men who subsequently reported first MI compared with age- and smoking-matched control subjects. Specifically, the relative risks of future MI associated with Chlamydia pneumoniae IgG titers >/=1:16, 1:32, 1:64, 1:128, and 1:256 were 1.1, 1.0, 1.1, 1.0, and 0.8, respectively (all probability values not significant). There was no association in analyses adjusted for other risk factors, evaluating early as compared with late events, or among nonsmokers. Further, there was no association between seropositivity and concentration of C-reactive protein, a marker of inflammation that predicts MI risk in this cohort.
In a large-scale study of socioeconomically homogeneous men that controlled for age, smoking, and other cardiovascular risk factors, we found no evidence of association between Chlamydia pneumoniae IgG seropositivity and risks of future MI.
有假说认为肺炎衣原体在动脉粥样硬化血栓形成过程中发挥作用。然而,关于接触肺炎衣原体与未来心肌梗死(MI)风险之间关系的前瞻性数据较为稀少。
在一项近15000名健康男性的前瞻性队列研究中,我们检测了从343名研究参与者的基线血样中针对肺炎衣原体的IgG抗体,这些参与者随后报告了首次心肌梗死,同时检测了相同数量的年龄和吸烟情况相匹配的对照受试者的抗体,这些对照受试者在12年随访期内未报告血管疾病。针对肺炎衣原体的IgG抗体的研究对象比例随年龄和吸烟量增加而升高。然而,随后报告首次心肌梗死的男性与年龄和吸烟情况相匹配的对照受试者在基线时肺炎衣原体IgG血清阳性率几乎相同。具体而言,肺炎衣原体IgG滴度≥1:16、1:32、1:64、1:128和1:256的未来心肌梗死相对风险分别为1.1、1.0、1.1、1.0和0.8(所有概率值均无统计学意义)。在针对其他风险因素进行校正的分析中、评估早期事件与晚期事件时以及在不吸烟者中均未发现关联。此外,血清阳性与C反应蛋白浓度之间也无关联,C反应蛋白是一种炎症标志物,可预测该队列中的心肌梗死风险。
在一项对社会经济状况相同的男性进行的大规模研究中,控制了年龄、吸烟和其他心血管风险因素,我们未发现肺炎衣原体IgG血清阳性与未来心肌梗死风险之间存在关联的证据。