Copyright © 2002 by the European Society of Cardiology.
Chlamydia pneumoniae IgA titres and coronary heart disease. Prospective study and meta-analysis
a Department of Public Health and Primary Care, University of Cambridge, Cambridge, U.K.
c Clinical Trial Service Unit and Epidemiological Studies Unit, University of Oxford, Oxford, U.K.
b Department of Public Health Sciences, St George's Hospital Medical School, London, U.K.
d Department of Population Sciences and Primary Care, Royal Free University College London Medical School, London, U.K.
e Departments of Cardiology and Molecular Microbiology, University of Southampton, Southampton, U.K.
revised May 10, 2001; accepted May 16, 2001
Abstract
Aims To examine associations between Chlamydia pneumoniae IgA titres and incident coronary heart disease, and to compare them with associations previously reported between C. pneumoniae IgG titres and coronary heart disease.
Methods and Results We measured serum concentrations ofC. pneumoniae IgA antibodies in 502 coronary heart disease cases and in 1005 age- and town-matched controls ‘nested’ in a community-based prospective study of 5661 British men (mean follow-up in controls, 16 years), and conducted a meta-analysis of published prospective studies to place our findings in context. Two hundred and twenty-one (44%) of the cases were in the top third of C. pneumoniae IgA titres compared with 336 (33%) of the controls, yielding an odds ratio for coronary heart disease of 1·84 (95% confidence interval 1·40–2·43) which was largely unchanged after adjustment. In aggregate, the present study and nine previously reported prospective studies of C. pneumoniae IgA titres involved 2283 cases, yielding a combined odds ratio for coronary heart disease of 1·25 (1·03–1·53), with no significant heterogeneity among the ten studies (
29=7·8; P>0·1). This combined odds ratio is compatible with that previously reported for C. pneumoniae IgG titres and coronary heart disease (1·15, 0·97–1·36).
Conclusion Neither C. pneumoniae IgA titres nor IgG titres are strongly predictive of coronary heart disease in the general population.
Key Words: Coronary heart disease, infection, Chlamydia pneumoniae, epidemiology
f1 Correspondence: J. Danesh, CTS Department of Public Health and Primary Care, Cambridge CB2 2SR, U.K.
References
- Danesh J, Whincup P, Walker M. Chlamydia pneumoniae IgG titres and coronary heart disease: prospective study and meta-analysis. BMJ. 2000;321:208–213
[Abstract/Free Full Text] - Elkind MSV, Lin I-F, Grayston JT. Chlamydia pneumoniae and the risk of first ischemic stroke: the Northern Manhattan Stroke Study. Stroke. 2000;31:1521–1525
[Abstract/Free Full Text] - Roivainen M, Viik-Kajander M, Palosuo T. Infections, inflammation and the risk of coronary heart disease. Circulation. 2000;101:252–258
[Abstract/Free Full Text] - Whincup P, Danesh J, Walker M. Prospective study of virulent strains of Helicobacter pylori and coronary heart disease. Circulation. 2000;101:1647–1652
[Abstract/Free Full Text] - Wong Y-K, Sueur JM, Fall CHD. The species specificity of the microimmunofluorescence antibody test and comparisons with a time resolved fluoroscopic immunoassay for measuring antibodies against Chlamydia pneumoniae. J Clin Pathol. 1999;2:99–103
- Danesh J, Whincup P, Walker M. Low grade inflammation and coronary heart disease: prospective study and meta-analysis. BMJ. 2000;321:199–204
[Abstract/Free Full Text] - Wald NJ, Law MR, Morris JK. Chlamydia pneumoniae infection and mortality from ischaemic heart disease: results from a large prospective study. BMJ. 2000;321:204–207
[Abstract/Free Full Text] - Strachan DP, Carrington D, Mendall MA. Relation of Chlamydia pneumoniae serology to mortality and incidence of ischaemic heart disease over 13 years in the Caerphilly prospective heart disease study. BMJ. 1999;318:1035–1040
[Abstract/Free Full Text] - Tavendale R, Parratt D, Brook RA. Antibodies to Chlamydia pneumoniae antibodies do not predict subsequent CHD in the Scottish Heart Health and MONICA studies. Eur Soc Cardiol. 1999;:P2221
- Miettinen H, Lehto S, Saikku P. Association of Chlamydia pneumoniae and acute coronary heart disease events in non-insulin dependent diabetic and non-diabetic subjects in Finland. Eur Heart J. 1996;17:682–688
[Abstract/Free Full Text] - Saikku P, Leinonen M, Tenkanen L. Chronic Chlamydia pneumoniae infection as a risk factor for coronary heart disease in the Helsinki Heart Study. Ann Intern Med. 1992;116:273–278
[Abstract/Free Full Text] - Glader CA, Boman J, Saikku P. The proatherogenic properties of lipoprotein(a) may be enhanced through the formation of circulating immune complexes containing Chlamydia pneumoniae-specific IgG antibodies. Eur Heart J. 2000;21:639–646
[Abstract/Free Full Text] - Von Hertzen L, Isoaho R, Kivela SL. Relation of C pneumoniae antibodies to ischaemic heart disease. BMJ. 1999;:1575–1576
- Ossewaarde JM, Feskens EJ, De Vries A. Chlamydia pneumoniae is a risk factor for coronary heart disease in symptom-free elderly men, but Helicobacter pylori and cytomegalovirus are not. Epidemiol Infect. 1998;120:93–99[CrossRef][Medline]
- Danesh J, Youngman L, Clark S. Helicobacter pylori infection and early onset myocardial infarction: case-control and sibling pairs study. BMJ. 1999;319:1157–1162
[Abstract/Free Full Text]
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  A Steptoe, A Shamaei-Tousi, A Gylfe, B Henderson, S Bergstrom, and M Marmot Socioeconomic status, pathogen burden and cardiovascular disease risk Heart, December 1, 2007; 93(12): 1567 - 1570. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. J. Ott, N. E. El Mokhtari, M. Musfeldt, S. Hellmig, S. Freitag, A. Rehman, T. Kuhbacher, S. Nikolaus, P. Namsolleck, M. Blaut, et al. Detection of Diverse Bacterial Signatures in Atherosclerotic Lesions of Patients With Coronary Heart Disease Circulation, February 21, 2006; 113(7): 929 - 937. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. Paldanius, A. Bloigu, M. Alho, M. Leinonen, and P. Saikku Prevalence and Persistence of Chlamydia pneumoniae Antibodies in Healthy Laboratory Personnel in Finland Clin. Vaccine Immunol., May 1, 2005; 12(5): 654 - 659. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. P. Kim, C. A. Gaydos, B. J. Wood, J. P. Hardick, Y. Zhang, and L. M. Wahl Chlamydia pneumoniae Enhances Cytokine-Stimulated Human Monocyte Matrix Metalloproteinases through a Prostaglandin E2-Dependent Mechanism Infect. Immun., January 1, 2005; 73(1): 632 - 634. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 B. Ludewig, P. Krebs, and E. Scandella Immunopathogenesis of atherosclerosis J. Leukoc. Biol., August 1, 2004; 76(2): 300 - 306. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 T. Ohlenschlaeger, P. Garred, H. O. Madsen, and S. Jacobsen Mannose-Binding Lectin Variant Alleles and the Risk of Arterial Thrombosis in Systemic Lupus Erythematosus N. Engl. J. Med., July 15, 2004; 351(3): 260 - 267. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 V. Y. Hoymans, J. M. Bosmans, D. Ursi, W. Martinet, F. L. Wuyts, E. Van Marck, M. Altwegg, C. J. Vrints, and M. M. Ieven Immunohistostaining Assays for Detection of Chlamydia pneumoniae in Atherosclerotic Arteries Indicate Cross-Reactions with Nonchlamydial Plaque Constituents J. Clin. Microbiol., July 1, 2004; 42(7): 3219 - 3224. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. J. Littman, L. A. Jackson, E. White, M. D. Thornquist, C. A. Gaydos, and T. L. Vaughan Interlaboratory Reliability of Microimmunofluorescence Test for Measurement of Chlamydia pneumoniae-Specific Immunoglobulin A and G Antibody Titers Clin. Vaccine Immunol., May 1, 2004; 11(3): 615 - 617. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. Kamath and G.Y.H. Lip Fibrinogen: biochemistry, epidemiology and determinants QJM, October 1, 2003; 96(10): 711 - 729. [Full Text] [PDF]
|
|
|
|
|
|
T. Huittinen, M. Leinonen, L. Tenkanen, H. Virkkunen, M. Manttari, T. Palosuo, V. Manninen, and P. Saikku Synergistic Effect of Persistent Chlamydia pneumoniae Infection, Autoimmunity, and Inflammation on Coronary Risk Circulation, May 27, 2003; 107(20): 2566 - 2570. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. Danesh, P. Whincup, and M. Walker Chlamydia pneumoniae IgA titres and coronary heart disease: prospective study and meta-analysis Eur. Heart J., May 1, 2003; 24(9): 881 - 881. [Full Text] [PDF]
|
|
|
|
 |
|
 G. Tsirpanlis, S. Chatzipanagiotou, A. Ioannidis, S. Moutafis, C. Poulopoulou, and C. Nicolaou Detection of Chlamydia pneumoniae in peripheral blood mononuclear cells: correlation with inflammation and atherosclerosis in haemodialysis patients Nephrol. Dial. Transplant., May 1, 2003; 18(5): 918 - 923. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. D. Spence and J. Norris Infection, Inflammation, and Atherosclerosis Stroke, February 1, 2003; 34(2): 333 - 334. [Full Text] [PDF]
|
|
|
|
|
|
M. Paldanius, A. Bloigu, M. Leinonen, and P. Saikku Measurement of Chlamydia pneumoniae-Specific Immunoglobulin A (IgA) Antibodies by the Microimmunofluorescence (MIF) Method: Comparison of Seven Fluorescein-Labeled Anti-Human IgA Conjugates in an In-House MIF Test Using One Commercial MIF and One Enzyme Immunoassay Kit Clin. Vaccine Immunol., January 1, 2003; 10(1): 8 - 12. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. V. Kalayoglu, P. Libby, and G. I. Byrne Chlamydia pneumoniae as an Emerging Risk Factor in Cardiovascular Disease JAMA, December 4, 2002; 288(21): 2724 - 2731. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. West Chlamydia pneumoniae Eur. Heart J., December 1, 2002; 23(23): 1890 - 1890. [Full Text] [PDF]
|
|
|
|
|
|
F.-J. Neumann Chlamydia pneumoniae-Atherosclerosis Link: A Sound Concept in Search for Clinical Relevance Circulation, November 5, 2002; 106(19): 2414 - 2416. [Full Text] [PDF]
|
|
|
|
|
|
L. Wilhelmsen Inflammation, infection, and coronary heart disease Eur. Heart J., March 1, 2002; 23(5): 343 - 344. [Full Text] [PDF]
|
|
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||