Jha Hem Chandra, Prasad Jagdish, Mittal Aruna
Division of Tissue Culture/Microbiology, Institute of Pathology (ICMR), Safdarjung Hospital Campus, P.O. Box 4909, New Delhi 110029, India.
Heart Vessels. 2008 Nov;23(6):390-6. doi: 10.1007/s00380-008-1062-9. Epub 2008 Nov 27.
Atherosclerosis is increasingly recognized as a chronic inflammatory disease. A variety of infectious agents (Chlamydia pneumoniae, Helicobacter pylori, and cytomegalovirus [CMV]) and inflammatory marker such as high-sensitivity C-reactive protein (hs-CRP) have been found to be associated with atherosclerosis and its consequences. There is a need to know about the type and burden of infection in coronary artery disease (CAD) patients and the level of hs-CRP in India as there is growing evidence that a variety of pathogens are participating in the development and/or acceleration of at least pre-existing atherosclerosis. In addition, there is a need to find the association between these pathogens and conventional risk factors among CAD patients in India, to possibly identify a prognostic marker. In this study 192 patients with incident or prevalent CAD attending the Cardiology Outpatient Department of Safdarjung Hospital, New Delhi, India, were enrolled. In addition, 192 age-and sex-matched controls were also included. Cases and controls differ significantly in seropositivity to C. pneumoniae immunoglobulin IgA (154 vs 76) and IgG (71 vs 48) (P < 0.001, P < 0.015), H. pylori IgA (98 vs 57) and IgG (77 vs 43) (P < 0.001, P < 0.001), CMV IgG (62 vs 38) (P = 0.01) and with hs-CRP (114 vs 60) (P < 0.001), respectively. The level of hs-CRP was higher in CAD patients with IgA seropositivity of C. pneumoniae and H. pylori (5.18 and.65 mg/l) than the IgG of these bacteria (3.73 and 3.36 mg/l), respectively. These findings support an association between specific infectious agents, namely, C. pneumoniae, H. pylori, CMV, and hs-CRP in CAD patients. Association of hs-CRP with IgA specific for C. pneumoniae and H. pylori suggests the role of chronic infection in the development of CAD and may be used as a marker to target the population.
动脉粥样硬化越来越被认为是一种慢性炎症性疾病。人们发现多种感染因子（肺炎衣原体、幽门螺杆菌和巨细胞病毒[CMV]）以及炎症标志物如高敏C反应蛋白（hs-CRP）与动脉粥样硬化及其后果相关。由于越来越多的证据表明多种病原体参与了至少已存在的动脉粥样硬化的发展和/或加速过程，因此有必要了解印度冠心病（CAD）患者的感染类型和负担以及hs-CRP水平。此外，有必要找出这些病原体与印度CAD患者传统危险因素之间的关联，以便有可能确定一个预后标志物。在本研究中，纳入了印度新德里萨夫达容医院心脏病门诊的192例新发或现患CAD患者。此外，还纳入了192例年龄和性别匹配的对照。病例组和对照组在肺炎衣原体免疫球蛋白IgA（154对76）和IgG（71对48）（P<0.001，P<0.015）、幽门螺杆菌IgA（98对57）和IgG（77对43）（P<0.001，P<0.001）、CMV IgG（62对38）（P = 0.01）以及hs-CRP（114对60）（P<0.001）的血清阳性率方面存在显著差异。肺炎衣原体和幽门螺杆菌IgA血清阳性的CAD患者的hs-CRP水平（分别为5.18和0.65mg/l）高于这些细菌IgG血清阳性的患者（分别为3.73和3.36mg/l）。这些发现支持了CAD患者中特定感染因子，即肺炎衣原体、幽门螺杆菌、CMV和hs-CRP之间的关联。hs-CRP与肺炎衣原体和幽门螺杆菌特异性IgA的关联表明慢性感染在CAD发展中的作用，并且可作为针对人群的一个标志物。
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