Document Detail


Serologic markers of persistent Chlamydia pneumonia infection and long-term prognosis after successful coronary stenting.
MedLine Citation:
PMID:  14661003     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
Michael N Zairis; Olga A Papadaki; Paraskevi K Psarogianni; Maria A Thoma; George K Andrikopoulos; Pelagia C Batika; Christina G Poulopoulou; Kyriaki G Trifinopoulou; Christopher D Olympios; Stefanos G Foussas
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  American heart journal     Volume:  146     ISSN:  1097-6744     ISO Abbreviation:  Am. Heart J.     Publication Date:  2003 Dec 
Date Detail:
Created Date:  2003-12-08     Completed Date:  2004-01-13     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0370465     Medline TA:  Am Heart J     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1082-9     Citation Subset:  AIM; IM    
Affiliation:
Department of Cardiology, Tzanio Hospital, Piraeus, Greece. zairis@hellasnet.gr
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MeSH Terms
Descriptor/Qualifier:
Aged
Analysis of Variance
Angina Pectoris / blood,  microbiology,  therapy
Antibodies, Bacterial / blood*
Biological Markers / blood
C-Reactive Protein / analysis*
Chlamydia Infections*
Chlamydophila pneumoniae / immunology*
Cohort Studies
Coronary Angiography
Coronary Artery Disease / blood*,  microbiology,  therapy
Female
Humans
Immunoglobulin A / blood
Immunoglobulin G / blood
Male
Middle Aged
Myocardial Infarction / blood*,  microbiology,  therapy
Prognosis
Prospective Studies
Statistics, Nonparametric
Stents*
Syndrome
Chemical
Reg. No./Substance:
0/Antibodies, Bacterial; 0/Biological Markers; 0/Immunoglobulin A; 0/Immunoglobulin G; 9007-41-4/C-Reactive Protein

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