Myocardial ischemia and infarction are associated with elevated Chlamydia pneumoniae IgA levels

Sreekumar - Subramanian, D. M. Niemeyer, P. D. McWhirter

Research output: Contribution to journalArticle

Abstract

Purpose: A growing body of literature has implicated the obligate intracellular bacterium, Chlamydia pneumoniae (CP), in the pathogenesis of atherosclerotic coronary artery disease (CAD). The purpose of the present study was to determine whether patients who rule in for myocardial ischemia or infarction are more likely to have serologic evidence of recent CP infection than those ruling out. Methods: Between August 1997 and February 1998, 70 patients were placed on the rule-out myocardial infarction (MI) protocol at our institution. Serum samples were drawn and analyzed for the presence of IgG, IgA and IgM antibodies to CP using a microimmunofluorescence assay. Patient demographics and risk factors for CAD were recorded in a database. Results: CP IgA levels were elevated in 21 of 70 patients (30%). Patients with elevated IgA levels were more likely to rule in for myocardial ischemia than those with normal titers (43% vs. 14%, p < 0.025). The relative risk of having myocardial ischemia with elevated IgA levels was 3.00. Of the 70 patients, 16 patients (23%) had objective evidence of myocardial ischemia or infarction (Group 1), while 54 patients (77%) did not (Group 2). CP IgA levels were more likely to be elevated in Group 1 patients (p < 0.025), although CP IgG levels, presence of hypertension (HTN), and hyperlipoproteinemia (HLP) were comparable between the groups. GROUP 1 n = 16 GROUP 2 n = 54 P value HIGH IgA 56% 22% < 0.025 HIGH IgG 81% 83% NS HTN 94% 72% NS HLP 62% 35% NS NS = Not Significant (P > 0.05) Conclusions: Elevated CP IgA titers are significantly more likely to be present in patients with objective evidence of myocardial ischemia or infarction. Clinical Implications: Acute infection or re-infection with Chlamydia pneumoniae may destabilize atherosclerotic plaques. Subsequent plaque rupture may result in myocardial ischemia and/or infarction.

Original languageEnglish (US)
JournalChest
Volume114
Issue number4 SUPPL.
StatePublished - Oct 1998
Externally publishedYes

Fingerprint

Chlamydophila pneumoniae
Immunoglobulin A
Myocardial Ischemia
Myocardial Infarction
Coronary Artery Disease
Chlamydia Infections
Atherosclerotic Plaques
Infection
Immunoglobulin M
Rupture
Immunoglobulin G
Demography
Databases
Bacteria
Antibodies
Serum

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine

Cite this

Myocardial ischemia and infarction are associated with elevated Chlamydia pneumoniae IgA levels. / Subramanian, Sreekumar -; Niemeyer, D. M.; McWhirter, P. D.

In: Chest, Vol. 114, No. 4 SUPPL., 10.1998.

Research output: Contribution to journalArticle

@article{8de7c59b33e0468aa6ea971476d37068,
title = "Myocardial ischemia and infarction are associated with elevated Chlamydia pneumoniae IgA levels",
abstract = "Purpose: A growing body of literature has implicated the obligate intracellular bacterium, Chlamydia pneumoniae (CP), in the pathogenesis of atherosclerotic coronary artery disease (CAD). The purpose of the present study was to determine whether patients who rule in for myocardial ischemia or infarction are more likely to have serologic evidence of recent CP infection than those ruling out. Methods: Between August 1997 and February 1998, 70 patients were placed on the rule-out myocardial infarction (MI) protocol at our institution. Serum samples were drawn and analyzed for the presence of IgG, IgA and IgM antibodies to CP using a microimmunofluorescence assay. Patient demographics and risk factors for CAD were recorded in a database. Results: CP IgA levels were elevated in 21 of 70 patients (30{\%}). Patients with elevated IgA levels were more likely to rule in for myocardial ischemia than those with normal titers (43{\%} vs. 14{\%}, p < 0.025). The relative risk of having myocardial ischemia with elevated IgA levels was 3.00. Of the 70 patients, 16 patients (23{\%}) had objective evidence of myocardial ischemia or infarction (Group 1), while 54 patients (77{\%}) did not (Group 2). CP IgA levels were more likely to be elevated in Group 1 patients (p < 0.025), although CP IgG levels, presence of hypertension (HTN), and hyperlipoproteinemia (HLP) were comparable between the groups. GROUP 1 n = 16 GROUP 2 n = 54 P value HIGH IgA 56{\%} 22{\%} < 0.025 HIGH IgG 81{\%} 83{\%} NS HTN 94{\%} 72{\%} NS HLP 62{\%} 35{\%} NS NS = Not Significant (P > 0.05) Conclusions: Elevated CP IgA titers are significantly more likely to be present in patients with objective evidence of myocardial ischemia or infarction. Clinical Implications: Acute infection or re-infection with Chlamydia pneumoniae may destabilize atherosclerotic plaques. Subsequent plaque rupture may result in myocardial ischemia and/or infarction.",
author = "Subramanian, {Sreekumar -} and Niemeyer, {D. M.} and McWhirter, {P. D.}",
year = "1998",
month = "10",
language = "English (US)",
volume = "114",
journal = "Chest",
issn = "0012-3692",
publisher = "American College of Chest Physicians",
number = "4 SUPPL.",

}

TY - JOUR

T1 - Myocardial ischemia and infarction are associated with elevated Chlamydia pneumoniae IgA levels

AU - Subramanian, Sreekumar -

AU - Niemeyer, D. M.

AU - McWhirter, P. D.

PY - 1998/10

Y1 - 1998/10

N2 - Purpose: A growing body of literature has implicated the obligate intracellular bacterium, Chlamydia pneumoniae (CP), in the pathogenesis of atherosclerotic coronary artery disease (CAD). The purpose of the present study was to determine whether patients who rule in for myocardial ischemia or infarction are more likely to have serologic evidence of recent CP infection than those ruling out. Methods: Between August 1997 and February 1998, 70 patients were placed on the rule-out myocardial infarction (MI) protocol at our institution. Serum samples were drawn and analyzed for the presence of IgG, IgA and IgM antibodies to CP using a microimmunofluorescence assay. Patient demographics and risk factors for CAD were recorded in a database. Results: CP IgA levels were elevated in 21 of 70 patients (30%). Patients with elevated IgA levels were more likely to rule in for myocardial ischemia than those with normal titers (43% vs. 14%, p < 0.025). The relative risk of having myocardial ischemia with elevated IgA levels was 3.00. Of the 70 patients, 16 patients (23%) had objective evidence of myocardial ischemia or infarction (Group 1), while 54 patients (77%) did not (Group 2). CP IgA levels were more likely to be elevated in Group 1 patients (p < 0.025), although CP IgG levels, presence of hypertension (HTN), and hyperlipoproteinemia (HLP) were comparable between the groups. GROUP 1 n = 16 GROUP 2 n = 54 P value HIGH IgA 56% 22% < 0.025 HIGH IgG 81% 83% NS HTN 94% 72% NS HLP 62% 35% NS NS = Not Significant (P > 0.05) Conclusions: Elevated CP IgA titers are significantly more likely to be present in patients with objective evidence of myocardial ischemia or infarction. Clinical Implications: Acute infection or re-infection with Chlamydia pneumoniae may destabilize atherosclerotic plaques. Subsequent plaque rupture may result in myocardial ischemia and/or infarction.

AB - Purpose: A growing body of literature has implicated the obligate intracellular bacterium, Chlamydia pneumoniae (CP), in the pathogenesis of atherosclerotic coronary artery disease (CAD). The purpose of the present study was to determine whether patients who rule in for myocardial ischemia or infarction are more likely to have serologic evidence of recent CP infection than those ruling out. Methods: Between August 1997 and February 1998, 70 patients were placed on the rule-out myocardial infarction (MI) protocol at our institution. Serum samples were drawn and analyzed for the presence of IgG, IgA and IgM antibodies to CP using a microimmunofluorescence assay. Patient demographics and risk factors for CAD were recorded in a database. Results: CP IgA levels were elevated in 21 of 70 patients (30%). Patients with elevated IgA levels were more likely to rule in for myocardial ischemia than those with normal titers (43% vs. 14%, p < 0.025). The relative risk of having myocardial ischemia with elevated IgA levels was 3.00. Of the 70 patients, 16 patients (23%) had objective evidence of myocardial ischemia or infarction (Group 1), while 54 patients (77%) did not (Group 2). CP IgA levels were more likely to be elevated in Group 1 patients (p < 0.025), although CP IgG levels, presence of hypertension (HTN), and hyperlipoproteinemia (HLP) were comparable between the groups. GROUP 1 n = 16 GROUP 2 n = 54 P value HIGH IgA 56% 22% < 0.025 HIGH IgG 81% 83% NS HTN 94% 72% NS HLP 62% 35% NS NS = Not Significant (P > 0.05) Conclusions: Elevated CP IgA titers are significantly more likely to be present in patients with objective evidence of myocardial ischemia or infarction. Clinical Implications: Acute infection or re-infection with Chlamydia pneumoniae may destabilize atherosclerotic plaques. Subsequent plaque rupture may result in myocardial ischemia and/or infarction.

UR - http://www.scopus.com/inward/record.url?scp=33750251897&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=33750251897&partnerID=8YFLogxK

M3 - Article

VL - 114

JO - Chest

JF - Chest

SN - 0012-3692

IS - 4 SUPPL.

ER -