Pediatric Cardiology, University Hospital of Lund, Getingevägen 4, Lund SE-221 85, Sweden.
Heart Lung. 2009 May-Jun;38(3):176-81. doi: 10.1016/j.hrtlng.2008.06.001. Epub 2008 Oct 5.
Infections caused by Chlamydia pneumoniae are considered to participate in inflammatory processes leading to coronary artery disease. After a primary infection, the bacteria remain dormant intracellularly causing a chronic inflammatory stimulus.
Blood samples were obtained from 235 patients with acute myocardial infarction (AMI) and 108 patients with unstable angina pectoris (UA). We evaluated the prognostic significance of bacterial and viral antibody titers, serum troponin T, C-reactive protein, and chlamydial lipopolysaccharide (cLPS) concentrations during acute coronary syndrome of patients with AMI and UA for cardiovascular death and new UA and AMI that required hospital care during a 6-year follow-up.
Serum cLPS levels correlated with C-reactive protein and serum troponin T concentrations during acute coronary events. Patients with AMI had significantly higher serum concentration of cLPS compared with patients with UA. Enterovirus antibody titers and cholesterol-lowering therapy at admission of the index event were negatively correlated with cLPS concentration (r = -.198, P = .0003 and r = -.26, P = .019, respectively). The presence of circulating cLPS was associated with a hazard ratio of 2.04 for a new cardiovascular event during the follow-up period (P = .006). The area under the curve in the receiver operating graph was .572.
cLPS is evidently liberated from the infected atherosclerotic tissue during an acute coronary event. Our study supports the view that inflammation caused by C. pneumoniae infection is an important but as yet poorly understood factor in the development of atherosclerosis and may play a role in acute vascular events.
肺炎衣原体引起的感染被认为参与了导致冠状动脉疾病的炎症过程。初次感染后，细菌在细胞内休眠，引起慢性炎症刺激。
从 235 名急性心肌梗死（AMI）患者和 108 名不稳定型心绞痛（UA）患者中采集血样。我们评估了细菌和病毒抗体滴度、血清肌钙蛋白 T、C 反应蛋白和肺炎衣原体脂多糖（cLPS）浓度在 AMI 和 UA 急性冠状动脉综合征患者中的预后意义，以预测心血管死亡和新的 UA 和 AMI，并在 6 年的随访期间需要住院治疗。
血清 cLPS 水平与急性冠状动脉事件期间的 C 反应蛋白和血清肌钙蛋白 T浓度相关。AMI 患者的血清 cLPS 浓度明显高于 UA 患者。入院时的肠病毒抗体滴度和降脂治疗与 cLPS 浓度呈负相关（r = -.198，P =.0003 和 r = -.26，P =.019）。循环 cLPS 的存在与随访期间新发心血管事件的风险比为 2.04（P =.006）。受试者工作特征曲线下的面积为.572。
cLPS 在急性冠状动脉事件期间显然从感染的动脉粥样硬化组织中释放出来。我们的研究支持这样一种观点，即肺炎衣原体感染引起的炎症是动脉粥样硬化发展的一个重要但尚未被充分了解的因素，可能在急性血管事件中发挥作用。
