Association of Chlamydia pneumoniae and acute coronary heart disease events in non-insulin dependent diabetic and non-diabetic subjects in Finland.

OBJECTIVE It has been suggested that Chlamydia pneumoniae, a Gram-negative intracellular bacterium, is a risk factor for both myocardial infarction and chronic coronary heart disease. Previous studies have been done predominantly in non-diabetic subjects and thus the effect of diabetes on the association between C. pneumoniae antibodies and coronary heart disease has not been analysed. The aim of our study was to investigate the association between prior chlamydial infection and the risk of serious coronary heart disease events (myocardial infarction or coronary death) in a 7-year prospective study of cohorts of diabetic and non-diabetic subjects in two areas of Finland. RESULTS It was found that the prevalence of elevated chlamydial antibodies at baseline was higher in nondiabetic subjects who had serious coronary heart disease events during the follow-up than in subjects without coronary heart disease events (32 vs 15%, relative risk 2.56, P = 0.013) in East Finland. In non-diabetic subjects living in West Finland we did not find this association. The association between the C. pneumoniae antibodies and coronary heart disease events did not markedly change after controlling for other risk factors for coronary heart disease (OR 2.44, P = 0.055) in non-diabetic subjects living in eastern Finland. In diabetic patients we did not find any association between chlamydial antibodies and coronary heart disease events. CONCLUSION We found an association between C. pneumoniae antibodies and coronary heart disease events in non-diabetics living in eastern Finland. This association remained strong even after controlling for the other risk factors for coronary heart disease. In diabetic patients with high risk for coronary heart disease, C. pneumoniae was not a risk factor for coronary heart disease.

[1]  J. Tuomilehto,et al.  Importance of smoking for Chlamydia pneumoniae seropositivity. , 1994, International journal of epidemiology.

[2]  E. Vartiainen,et al.  Changes in risk factors explain changes in mortality from ischaemic heart disease in Finland , 1994, BMJ.

[3]  D. Strachan,et al.  Relation of Helicobacter pylori infection and coronary heart disease. , 1994, British heart journal.

[4]  T. Tuomi,et al.  Interference of immunoglobulin G (IgG) antibodies in IgA antibody determinations of Chlamydia pneumoniae by microimmunofluorescence test , 1994, Journal of clinical microbiology.

[5]  J. Tuomilehto,et al.  Chlamydia pneumoniae IgG antibody prevalence in south-western and eastern Finland in 1982 and 1987. , 1994, International journal of epidemiology.

[6]  A. Gown,et al.  Detection of Chlamydia pneumoniae in aortic lesions of atherosclerosis by immunocytochemical stain. , 1993, Arteriosclerosis and thrombosis : a journal of vascular biology.

[7]  H. Fukushi,et al.  Demonstration of Chlamydia pneumoniae in atherosclerotic lesions of coronary arteries. , 1993, The Journal of infectious diseases.

[8]  M. Nieminen,et al.  Chlamydia Pneumoniae‐Specific Circulating Immune Complexes in Patients With Chronic Coronary Heart Disease , 1993, Circulation.

[9]  V. Salomaa,et al.  Trends in the incidence of and mortality from coronary heart disease in Finland, 1983-1988. , 1992, American journal of epidemiology.

[10]  D. Patton,et al.  Detection of Chlamydia pneumoniae in coronary arterial fatty streaks and atheromatous plaques. , 1992, South African medical journal = Suid-Afrikaanse tydskrif vir geneeskunde.

[11]  D. Hahn,et al.  Smoking is a potential confounder of the Chlamydia pneumoniae-coronary artery disease association. , 1992, Arteriosclerosis and thrombosis : a journal of vascular biology.

[12]  D. L. Hahn.  Chlamydia, smoking, and heart disease. , 1992, Annals of internal medicine.

[13]  D. Siscovick,et al.  Association of prior infection with Chlamydia pneumoniae and angiographically demonstrated coronary artery disease. , 1992, JAMA.

[14]  V. Salomaa,et al.  Acute myocardial infarction (AMI) in Finland--baseline data from the FINMONICA AMI register in 1983-1985. , 1992, European heart journal.

[15]  M. Leinonen,et al.  Chronic Chlamydia pneumoniae Infection as a Risk Factor for Coronary Heart Disease in the Helsinki Heart Study , 1992, Annals of Internal Medicine.

[16]  R. Kronmal,et al.  Chlamydia pneumoniae strain TWAR antibody and angiographically demonstrated coronary artery disease. , 1991, Arteriosclerosis and thrombosis : a journal of vascular biology.

[17]  P. Saikku,et al.  A NEW RESPIRATORY TRACT PATHOGEN: CHLAMYDIA PNEUMONIAE STRAIN TWAR , 1990, The Journal of infectious diseases.

[18]  M. Nieminen,et al.  SEROLOGICAL EVIDENCE OF AN ASSOCIATION OF A NOVEL CHLAMYDIA, TWAR, WITH CHRONIC CORONARY HEART DISEASE AND ACUTE MYOCARDIAL INFARCTION , 1988, The Lancet.

[19]  M. Laakso,et al.  Atherosclerotic Vascular Disease and Its Risk Factors in Non-Insulin-Dependent Diabetic and Nondiabetic Subjects in Finland , 1988, Diabetes Care.

[20]  M. Laakso,et al.  Diabetes and atherosclerosis: an epidemiologic view. , 1987, Diabetes/metabolism reviews.

[21]  R. Ross.  The pathogenesis of atherosclerosis--an update. , 1986, The New England journal of medicine.

[22]  A. Reunanen,et al.  Incidence of different manifestations of coronary heart disease in middle-aged Finnish men and women. , 2009, Acta medica Scandinavica.

[23]  J. Salonen,et al.  Trends in coronary heart disease mortality and morbidity and related factors in Finland. , 1985, Cardiology.

[24]  D. Spodick,et al.  Association of acute respiratory symptoms with onset of acute myocardial infarction: prospective investigation of 150 consecutive patients and matched control patients. , 1984, The American journal of cardiology.

[25]  O. Siitonen,et al.  Acute myocardial infarction precipitated by infectious disease. , 1981, American heart journal.

[26]  A. Keys,et al.  Seven countries. A multivariate analysis of death and coronary heart disease. , 1980 .

[27]  G. Kostner.  Letter: Enzymatic determination of cholesterol in high-density lipoprotein fractions prepared by polyanion precipitation. , 1976, Clinical chemistry.

[28]  Bridget Wilcken,et al.  Pathogenesis of coronary artery disease , 1969 .