Serologic markers of persistent Chlamydia pneumonia infection and long-term prognosis after successful coronary stenting.

Autor: Zairis MN; Department of Cardiology, Tzanio Hospital, Piraeus, Greece. zairis@hellasnet.gr, Papadaki OA, Psarogianni PK, Thoma MA, Andrikopoulos GK, Batika PC, Poulopoulou CG, Trifinopoulou KG, Olympios CD, Foussas SG
Jazyk: angličtina
Zdroj: American heart journal [Am Heart J] 2003 Dec; Vol. 146 (6), pp. 1082-9.
DOI: 10.1016/S0002-8703(03)00503-9
Abstrakt: Background: Previous studies have shown an incremental role of inflammation in late prognosis following coronary stenting (CS). In particular, high preprocedural levels of plasma C-reactive protein (CRP) have been related to increased hazard of late ischemic complications. Persistent Chlamydia pneumoniae (Cp) infection, detected by positive IgA anti-Cp titers, may be associated with this inflammatory process and portend a high risk of late adverse prognosis after CS.
Methods: A total of 483 consecutive patients with either stable or unstable coronary syndromes were followed-up for 1 year after successful CS. The composite of cardiac death, myocardial infarction, rehospitalization for rest-unstable angina, and exertional angina, whichever occurred first, was the clinical end point. Additionally, the rate of in-stent restenosis and progression of coronary artery disease during this period were evaluated. Anti-Cp titers and plasma CRP levels were measured before the procedure.
Results: Positive immunoglobulin A (IgA), but not positive immunoglobulin G (IgG), titers were significantly associated with high plasma CRP levels in patients with unstable coronary syndromes (P =.005), but not in those with stable angina (P =.7). Moreover, positive IgA titers were significantly related to increased risk of both the composite clinical end point (P =.04) and progression of coronary artery disease (P <.001) in patients with unstable coronary syndromes but not in those with stable angina. Neither positive IgA nor positive IgG titers were associated with the rate of in-stent restenosis.
Conclusions: Persistent Cp infection may drive an inflammatory response in the coronary vasculature and portends an adverse late outcome after CS in patients with unstable coronary syndromes.
Databáze: MEDLINE
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