BMJ 2000;321:204-207 ( 22 July )

Papers

Chlamydia pneumoniae infection and mortality from ischaemic heart disease: large prospective study

Editorial by Koenig

N J Wald, professor, ^a M R Law, reader, ^a J K Morris, statistician, ^a X Zhou, research assistant, ^b Y Wong, research registrar, ^b M E Ward, professor. ^b

^a BUPA Epidemiological Research Group, Wolfson Institute of Preventive Medicine, St Bartholomew's and the Royal London School of Medicine and Dentistry, London EC1M 6BQ, ^b Molecular Microbiology Group, Southampton General Hospital, Southampton SO16 6YD

Correspondence to: N J Wald n.j.wald{at}mds.qmw.ac.uk

Objective: To determine whether there is an independent association between infection with Chlamydia pneumoniae and ischaemic heart disease.
Design: Prospective study using a nested case-control design.
Setting: Medical centre in London run by BUPA, a private medical organisation.
Participants: 21 520 professional men aged 35-64 who attended for a medical examination in London between 1975 and 1982.
Main outcome measure: Death from ischaemic heart disease.
Results: The distributions of concentrations of IgG and IgA antibodies to C pneumoniae were similar in the 647 men who subsequently died of ischaemic heart disease and in 1294 age matched controls who did not. There was no material association with heart disease irrespective of the cut-off point chosen to define seropositivity. At a cut-off point that defines 15% of controls as positive, for example, the odds ratios were 1.26 (95% confidence interval 0.95 to 1.68) for IgG and 1.09 (0.82 to 1.43) for IgA.
Conclusions: No material association was found between infection with C pneumoniae and ischaemic heart disease. The size and prospective design of the study and the socioeconomic homogeneity of the cohort minimise both random and systematic error.

---

© BMJ 2000
CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    StumbleUpon    Technorati    What's this?

Relevant Articles

Hearts and minds and meta-analyses
BMJ 2000 321: 0. [Full Text] [PDF]

Hearts and minds and meta-analyses
BMJ 2000 321: 0. [Full Text] [PDF]

C pneumoniae infection is not strongly associated with heart disease
BMJ 2000 321: 0. [Full Text]

Heart disease and the inflammatory response

Wolfgang Koenig
BMJ 2000 321: 187-188. [Extract] [Full Text] [PDF]

This article has been cited by other articles:

• Crawford, D. C., Sanders, C. L., Qin, X., Smith, J. D., Shephard, C., Wong, M., Witrak, L., Rieder, M. J., Nickerson, D. A. (2006). Genetic Variation Is Associated With C-Reactive Protein Levels in the Third National Health and Nutrition Examination Survey. Circulation 114: 2458-2465 [Abstract] [Full text]  
• Romics, L. Jr, Szabo, G., Coffey, J. C., Wang, J. H., Redmond, H. P. (2006). The Emerging Role of Toll-Like Receptor Pathways in Surgical Diseases. Arch Surg 141: 595-601 [Abstract] [Full text]  
• Njamnshi, A. K., Blackett, K. N., Mbuagbaw, J. N., Gumedze, F., Gupta, S., Wiysonge, C. S. (2006). Chronic Chlamydia pneumoniae Infection and Stroke in Cameroon: A Case-Control Study. Stroke 37: 796-799 [Abstract] [Full text]  
• Hsieh, J. C., Tham, D. M., Feng, W., Huang, F., Embaie, S., Liu, K., Dean, D., Hertle, R., FitzGerald, D. J., Mrsny, R. J. (2005). Intranasal Immunization Strategy To Impede Pilin-Mediated Binding of Pseudomonas aeruginosa to Airway Epithelial Cells. Infect. Immun. 73: 7705-7717 [Abstract] [Full text]  
• Mitusch, R., Luedemann, J., Wood, W. G., Berger, K., Schminke, U., Suter, M., Kessler, C., John, U., Rupp, J., Kentsch, M., Maass, M. (2005). Asymptomatic Carotid Atherosclerosis Is Associated With Circulating Chlamydia pneumoniae DNA in Younger Normotensive Subjects in a General Population Survey. Arterioscler. Thromb. Vasc. Bio. 25: 386-391 [Abstract] [Full text]  
• Zibaeenezhad, M. J., Amanat, A., Alborzi, A., Obudi, A. (2005). Relation of Chlamydia Pneumoniae Infection to Documented Coronary Artery Disease in Shiraz, Southern Iran. ANGIOLOGY 56: 43-48 [Abstract]  
• Agmon, Y., Khandheria, B. K., Meissner, I., Petterson, T. M., O'Fallon, W. M., Christianson, T. J. H., Wiebers, D. O., Smith, T. F., Steckelberg, J. M., Tajik, A. J. (2003). Lack of association between Chlamydia pneumoniae seropositivity and aortic atherosclerotic plaques: A Population-Based transesophageal echocardiographic study. J Am Coll Cardiol 41: 1482-1487 [Abstract] [Full text]  
• Paldanius, M., Bloigu, A., Leinonen, M., Saikku, P. (2003). 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. CVI 10: 8-12 [Abstract] [Full text]  
• Rugonfalvi-Kiss, S., Endresz, V., Madsen, H. O., Burian, K., Duba, J., Prohaszka, Z., Karadi, I., Romics, L., Gonczol, E., Fust, G., Garred, P. (2002). Association of Chlamydia pneumoniae With Coronary Artery Disease and Its Progression Is Dependent on the Modifying Effect of Mannose-Binding Lectin. Circulation 106: 1071-1076 [Abstract] [Full text]  
• Stollberger, C., Finsterer, J. (2002). Role of Infectious and Immune Factors in Coronary and Cerebrovascular Arteriosclerosis. CVI 9: 207-215 [Full text]  
• Danesh, J., Whincup, P., Lewington, S., Walker, M., Lennon, L., Thomson, A., Wong, Y.-K., Zhou, X., Ward, M. (2002). Chlamydia pneumoniae IgA titres and coronary heart disease. Prospective study and meta-analysis. Eur Heart J 23: 371-375 [Abstract] [Full text]  
• Taylor-Robinson, D, Thomas, B J, Goldin, R, Stanbridge, R (2002). Chlamydia pneumoniae in infrequently examined blood vessels. J. Clin. Pathol. 55: 218-220 [Abstract] [Full text]  
• Tavendale, R., Parratt, D., Pringle, S.D., A'brook, R., Tunstall-Pedoe, H. (2002). Serological markers of Chlamydia pneumoniae infection in men and women and subsequent coronary events. The Scottish Heart Health Study Cohort. Eur Heart J 23: 301-307 [Abstract] [Full text]  
• Tondella, M. L. C., Talkington, D. F., Holloway, B. P., Dowell, S. F., Cowley, K., Soriano-Gabarro, M., Elkind, M. S., Fields, B. S. (2002). Development and Evaluation of Real-Time PCR-Based Fluorescence Assays for Detection of Chlamydiapneumoniae. J. Clin. Microbiol. 40: 575-583 [Abstract] [Full text]  
• Boman, J., Hammerschlag, M. R. (2002). Chlamydia pneumoniae and Atherosclerosis: Critical Assessment of Diagnostic Methods and Relevance to Treatment Studies. Clin. Microbiol. Rev. 15: 1-20 [Abstract] [Full text]  
• Heuschmann, P. U., Neureiter, D., Gesslein, M., Craiovan, B., Maass, M., Faller, G., Beck, G., Neundoerfer, B., Kolominsky-Rabas, P. L. (2001). Association Between Infection With Helicobacter pylori and Chlamydia pneumoniae and Risk of Ischemic Stroke Subtypes: Results From a Population-Based Case-Control Study. Stroke 32: 2253-2258 [Abstract] [Full text]  
• Wiedermann, C. J., Kiechl, S., Schratzberger, P., Dunzendorfer, S., Weiss, G., Willeit, J. (2001). The role of immune activation in endotoxin-induced atherogenesis. Innate Immunity 7: 322-326 [Abstract]  
• Aalto-Setala, K., Laitinen, K., Erkkila, L., Leinonen, M., Jauhiainen, M., Ehnholm, C., Tamminen, M., Puolakkainen, M., Penttila, I., Saikku, P. (2001). Chlamydia pneumoniae Does Not Increase Atherosclerosis in the Aortic Root of Apolipoprotein E-Deficient Mice. Arterioscler. Thromb. Vasc. Bio. 21: 578-584 [Abstract] [Full text]  
• Jersmann, H. P. A., Hii, C. S. T., Ferrante, J. V., Ferrante, A. (2001). Bacterial Lipopolysaccharide and Tumor Necrosis Factor Alpha Synergistically Increase Expression of Human Endothelial Adhesion Molecules through Activation of NF-{kappa}B and p38 Mitogen-Activated Protein Kinase Signaling Pathways. Infect. Immun. 69: 1273-1279 [Abstract] [Full text]  
• Hughes, E. S., Shaw, K. M., Ashley, R. H. (2001). Mutagenesis and Functional Reconstitution of Chlamydial Major Outer Membrane Proteins: VS4 Domains Are Not Required for Pore Formation but Modify Channel Function. Infect. Immun. 69: 1671-1678 [Abstract] [Full text]  
• (2000). Association Between C. Pneumoniae and CHD Is Not Strong. Journal Watch Cardiology 2000: 3-3 [Full text]  
• Koenig, W. (2000). Heart disease and the inflammatory response. BMJ 321: 187-188 [Full text]  
• Danesh, J., Whincup, P., Walker, M., Lennon, L., Thomson, A., Appleby, P., Wong, Y.-k., Bernardes-Silva, M., Ward, M., West, R. (2000). Chlamydia pneumoniae IgG titres and coronary heart disease: prospective study and meta-analysis Commentary: Adjustment for potential confounders may have been taken too far. BMJ 321: 208-213 [Abstract] [Full text]  

Rapid Responses:

Read all Rapid Responses

C.pneumoniae and heart disease;the association is not disproved.

Zelma Hall
bmj.com, 21 Aug 2000 [Full text]

Relation of C pneumoniae infection and ischaemic heart disease cannot be solved serologically

David Taylor-Robinson
bmj.com, 19 Dec 2001 [Full text]

Online poll

Find out more >>