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Baseline IgG Antibody Titers to Chlamydia pneumoniae, Helicobacter pylori, Herpes Simplex Virus, and Cytomegalovirus and the Risk for Cardiovascular Disease in Women

Paul M. Ridker, MD; Charles H. Hennekens, MD; Julie E. Buring, ScD; Ruth Kundsin, PhD; and Jessie Shih, PhD
[+] Article, Author, and Disclosure Information

From Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts; and Abbott Laboratories, Abbott Park, Illinois.

Grant Support: By the National Heart, Lung, and Blood Institute (HL58755) and by an Established Investigator Award from the American Heart Association (Dr. Ridker).

Requests for Reprints: Paul M. Ridker, MD, Cardiovascular Division, Brigham and Women's Hospital, 75 Francis Street, Boston, MA 02115. For reprint orders in quantities exceeding 100, please contact the Reprints Coordinator; phone, 215-351-2657; e-mail, reprints@mail.acponline.org.

Current Author Addresses: Dr. Ridker: Cardiovascular Division, Brigham and Women's Hospital, 75 Francis Street, Boston, MA 02115.

Drs. Hennekens, Buring, and Kundsin: Department of Medicine, Brigham and Women's Hospital, 900 Commonwealth Avenue East, Boston, MA 02215.

Dr. Shih: Abbott Laboratories, D-9FS AP20, 100 Abbott Park Road, Abbott Park, IL 60064-6015.

Ann Intern Med. 1999;131(8):573-577. doi:10.7326/0003-4819-131-8-199910190-00004
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Data from several studies have suggested that persons with coronary heart disease have an increased prevalence of chronic infection with such agents as Chlamydia pneumoniae, Helicobacter pylori, herpes simplex virus, and cytomegalovirus (1). In addition, it has been hypothesized that infection may be a risk factor for acute coronary events (2). However, chronic infection is also more prevalent among smokers, elderly persons, and persons of lower socioeconomic status, and persons with a history of coronary disease may be more susceptible to subsequent infection. Therefore, it is uncertain whether the associations between infection and coronary heart disease that have been observed in retrospective and cross-sectional studies were caused by confounding or represent a result of ischemic heart disease rather than a cause (3).

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Figure 1.
Adjusted rate ratios for future cardiovascular events among apparently healthy women, according to the presence of baseline IgG antibody titers againstChlamydia pneumoniae, herpes simplex virus, cytomegalovirus, andHelicobacter pylori(top) and the number of positive baseline IgG titers present (bottom).

Error bars represent 95% CIs.

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Figure 2.
Distribution of C-reactive protein level, according to the number of positive baseline IgG antibody titers present.

Error bars represent 95% CIs.

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Summary for Patients

Chronic Infection and the Risk for Heart Disease

The summary below is from the full report titled “Baseline IgG Antibody Titers to Chlamydia pneumoniae, Helicobacter pylori, Herpes Simplex Virus, and Cytomegalovirus and the Risk for Cardiovascular Disease in Women.” It is in the 19 October 1999 issue of Annals of Internal Medicine (volume 131, pages 573-577). The authors are P.M. Ridker, C.H. Hennekens, J.E. Buring, R. Kundsin, and J. Shih.


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