Ridker P M, Hennekens C H, Buring J E, Kundsin R, Shih J
Cardiovascular Division, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts 02115, USA.
Ann Intern Med. 1999 Oct 19;131(8):573-7. doi: 10.7326/0003-4819-131-8-199910190-00004.
Results of cross-sectional and retrospective studies have suggested that chronic infection may be a risk factor for cardiovascular disease. However, prospective data evaluating the relation between baseline antibody titers against various plausible agents and risk for cardiovascular disease are sparse, particularly among women.
To determine whether previous exposure to Chlamydia pneumoniae, Helicobacter pylori, herpes simplex virus, or cytomegalovirus is associated with increased risk for cardiovascular events.
Prospective, nested, case-control study.
Women's Health Study.
Apparently healthy postmenopausal women.
IgG antibody titers against C. pneumoniae, H. pylori, herpes simplex virus, and cytomegalovirus were measured in baseline blood samples obtained from 122 study participants who subsequently reported a first cardiovascular event (case-patients) and 244 participants matched for age and smoking status who did not report a cardiovascular event (controls) during 3 years of follow-up.
Little evidence was found of an association between risk for cardiovascular events and baseline IgG seropositivity for antibodies against C. pneumoniae (rate ratio, 1.1 [95% CI, 0.7 to 1.8]), H. pylori (rate ratio, 0.90 [CI, 0.6 to 1.4]), herpes simplex virus (rate ratio, 1.2 [CI, 0.6 to 2.1]), and cytomegalovirus (rate ratio, 0.9 [CI, 0.6 to 1.5]). In addition, there was little evidence of an association between a participant's total number of infections and subsequent cardiovascular risk (P > 0.2).
In apparently healthy postmenopausal women, little evidence was found that previous infection, as measured by IgG antibody titers to C. pneumoniae, H. pylori, herpes simplex virus, and cytomegalovirus, is associated with subsequent risk for cardiovascular disease.
横断面研究和回顾性研究结果提示，慢性感染可能是心血管疾病的一个危险因素。然而，评估针对各种可能病原体的基线抗体滴度与心血管疾病风险之间关系的前瞻性数据较少，尤其是在女性中。
确定既往接触肺炎衣原体、幽门螺杆菌、单纯疱疹病毒或巨细胞病毒是否与心血管事件风险增加相关。
前瞻性巢式病例对照研究。
妇女健康研究。
表面健康的绝经后女性。
在从122名研究参与者（随后报告首次心血管事件的病例患者）和244名年龄及吸烟状况匹配、在3年随访期间未报告心血管事件的参与者（对照）采集的基线血样中，检测针对肺炎衣原体、幽门螺杆菌、单纯疱疹病毒和巨细胞病毒的IgG抗体滴度。
几乎没有证据表明心血管事件风险与针对肺炎衣原体抗体的基线IgG血清阳性（率比，1.1[95%CI，0.7至1.8]）、幽门螺杆菌（率比，0.90[CI，0.6至1.4]）、单纯疱疹病毒（率比，1.2[CI，0.6至2.1]）和巨细胞病毒（率比，0.9[CI，0.6至1.5]）之间存在关联。此外，几乎没有证据表明参与者的感染总数与随后的心血管风险之间存在关联（P>0.2）。
在表面健康的绝经后女性中，几乎没有证据表明，以针对肺炎衣原体、幽门螺杆菌、单纯疱疹病毒和巨细胞病毒的IgG抗体滴度衡量的既往感染与随后的心血管疾病风险相关。
