Tanne David, Haim Moti, Boyko Valentina, Goldbourt Uri, Reshef Tamar, Adler Yehuda, Brunner Daniel, Mekori Yoseph A, Behar Solomon
Stroke Unit, Department of Neurology, Sheba Medical Center, Tel-Hashomer, Israel.
Cerebrovasc Dis. 2003;16(2):166-70. doi: 10.1159/000070597.
Chlamydia pneumoniae infection or exposure to C. pneumoniae was implicated as a risk factor for ischemic stroke. Our aim was to evaluate prospectively the association between the presence of antibodies to C. pneumoniae (IgG and IgA) and the risk of incident ischemic stroke among patients with pre-existing vascular disease.
Sera were collected from 3,090 coronary heart disease patients enrolled in a secondary prevention trial. We measured baseline antibodies (IgG and IgA) in the sera of patients who developed subsequent ischemic strokes (cases, n = 134) during follow-up (mean 8.2 years), and in 134 age- and gender-matched pairs without subsequent stroke or myocardial infarction.
The crude relative odds (95%CI) of incident ischemic strokes in seropositive patients at baseline (>1.1 relative value units) were 1.29 (95%CI, 0.69-2.47) for IgG and 1.31 (95% CI, 0.69-2.55) for IgA by matched-pair analyses, and 1.42 (95%CI, 0.69-2.98) for IgG and 1.57 (95%CI, 0.76-3.35) for IgA after adjustments for conventional risk factors and the inflammatory marker, soluble intercellular adhesion molecule-1. We explored the possibility that the risk of ischemic stroke may increase in parallel to increasing antibody titers, but did not demonstrate any significant association.
Serological evidence for prior infection with C. pneumoniae did not emerge as an independent risk factor for incident ischemic stroke among patients at high risk due to pre-existing vascular disease.
肺炎衣原体感染或接触肺炎衣原体被认为是缺血性卒中的一个危险因素。我们的目的是前瞻性评估肺炎衣原体抗体（IgG和IgA）的存在与已有血管疾病患者发生缺血性卒中风险之间的关联。
从参与一项二级预防试验的3090例冠心病患者中采集血清。我们测量了在随访期间（平均8.2年）发生后续缺血性卒中的患者（病例组，n = 134）血清中的基线抗体（IgG和IgA），以及134例年龄和性别匹配、无后续卒中或心肌梗死的对照者血清中的基线抗体。
通过配对分析，基线时血清阳性患者（相对值>1.1单位）发生缺血性卒中的粗相对比值（95%CI），IgG为1.29（95%CI，0.69 - 2.47），IgA为1.31（95%CI，0.69 - 2.55）；在对传统危险因素和炎症标志物可溶性细胞间黏附分子-1进行调整后，IgG为1.42（95%CI，0.69 - 2.98），IgA为1.57（95%CI，0.76 - 3.35）。我们探讨了缺血性卒中风险可能随抗体滴度升高而增加的可能性，但未发现任何显著关联。
对于因已有血管疾病而处于高风险的患者，既往感染肺炎衣原体的血清学证据并未成为发生缺血性卒中的独立危险因素。
