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.
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