0

The full content of Annals is available to subscribers

Subscribe/Learn More  >
Articles |

Chronic Chlamydia pneumoniae Infection as a Risk Factor for Coronary Heart Disease in the Helsinki Heart Study

Pekka Saikku, MD, PhD; Maija Leinonen, PhD; Leena Tenkanen, MSc; Eila Linnanmäki, MSc; Marja-Riitta Ekman, MD; Vesa Manninen, MD, PhD; Matti Mänttäri, MD, PhD; M. Heikki Frick, MD, PhD; and Jussi K. Huttunen, MD, PhD
[+] Article and Author Information

Grant Support: By grants from the Medical Council, Academy of Finland, Sigrid Juselius Foundation (P.S.), and the Meilahti Foundation.

Requests for Reprints: Pekka Saikku, MD, PhD, Department of Virology, University of Helsinki, Haartmaninkatu 3, SF-00290 Helsinki, Finland.

Current Author Addresses: Drs. Saikku and Ekman and Ms. Linnanmäki: Department of Virology, University of Helsinki, Haartmaninkatu 3, SF-00290 Helsinki, Finland.

Drs. Leinonen and Huttunen: National Public Health Institute, Mannerheimintie 166, SF 00300 Helsinki, Finland.

Ms. Tenkanen: Department of Public Health, University of Tampere, P.O. Box 607, SF 33101 Tampere, Finland.

Drs. Mänttäri, Manninen, and Frick: First Department of Medicine, Helsinki University Central Hospital, Haartmaninkatu 4, SF-00290 Helsinki, Finland.


©1992 American College of PhysiciansAmerican College of Physicians


Ann Intern Med. 1992;116(4):273-278. doi:10.7326/0003-4819-116-4-273
Text Size: A A A

Objective: To investigate in the prospective Helsinki Heart Study, whether chronic Chlamydia pneumoniae infection, indicated by elevated antibody titers against the pathogen, chlamydial lipopolysaccharide-containing immune complexes, or both, is a risk factor for coronary heart disease.

Design and Setting: The Helsinki Heart Study was a randomized, double-blind, 5-year clinical trial to test the efficacy of gemfibrozil in reducing the risk for coronary heart disease. Participants were randomized to receive either gemfibrozil (2046 patients) or placebo (2035 patients). Fatal and nonfatal myocardial infarction and sudden cardiac death were the main study end points. Serum samples were collected at 3-month intervals from all patients.

Patients: One hundred forty cardiac events occurred during the follow-up period. Serum samples from 103 case patients obtained 3 to 6 months before a cardiac end point were matched with those from controls for time point, locality, and treatment. Samples were tested for markers of chronic chlamydial infection.

Measurements: Immunoglobulin A (IgA) and G (IgG) antibodies to C. pneumoniae were measured using the microimmunofluorescence method. Lipopolysaccharide-containing immune complexes were measured using two antigen-specific enzyme immunoassays, the lipopolysaccharide-capture and immunoglobulin M (lgM)-capture methods.

Main Results: Using a conditional logistic regression model, odds ratios for the development of coronary heart disease were 2.7 (95% Cl, 1.1 to 6.5) for elevated lgA titers, 2.1 (Cl, 1.1 to 3.9) for the presence of immune complexes, and 2.9 (Cl, 1.5 to 5.4) for the presence of both factors. If we adjusted for other coronary heart disease risk factors such as age, hypertension, and smoking, the corresponding values would be 2.3 (Cl, 0.9 to 6.2), 1.8 (Cl, 0.9 to 3.6), and 2.6 (Cl, 1.3 to 5.2), respectively.

Conclusion: The results suggest that chronic C. pneumoniae infection may be a significant risk factor for the development of coronary heart disease.

Figures

Tables

References

Letters

NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).

Comments

Submit a Comment
Submit a Comment

Summary for Patients

Clinical Slide Sets

Terms of Use

The In the Clinic® slide sets are owned and copyrighted by the American College of Physicians (ACP). All text, graphics, trademarks, and other intellectual property incorporated into the slide sets remain the sole and exclusive property of the ACP. The slide sets may be used only by the person who downloads or purchases them and only for the purpose of presenting them during not-for-profit educational activities. Users may incorporate the entire slide set or selected individual slides into their own teaching presentations but may not alter the content of the slides in any way or remove the ACP copyright notice. Users may make print copies for use as hand-outs for the audience the user is personally addressing but may not otherwise reproduce or distribute the slides by any means or media, including but not limited to sending them as e-mail attachments, posting them on Internet or Intranet sites, publishing them in meeting proceedings, or making them available for sale or distribution in any unauthorized form, without the express written permission of the ACP. Unauthorized use of the In the Clinic slide sets will constitute copyright infringement.

Toolkit

Buy Now

to gain full access to the content and tools.

Want to Subscribe?

Learn more about subscription options

Advertisement
Related Articles
Related Point of Care
Topic Collections
PubMed Articles

Buy Now

to gain full access to the content and tools.

Want to Subscribe?

Learn more about subscription options

Forgot your password?
Enter your username and email address. We'll send you a reminder to the email address on record.
(Required)
(Required)