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Chlamydia pneumoniae Seropositivity and Systemic and Renovascular Atherosclerotic Disease
Andre J. A. M. van der Ven, MD, PhD;
Marianne J. Hommels;
Abraham A. Kroon, MD, PhD;
Anton Kessels, MD;
Karin Flobbe, MSc;
Jos van Engelshoven, MD, PhD;
Catrien A. Bruggeman, PhD;
Peter W. de Leeuw, MD, PhD
Arch Intern Med. 2002;162:786-790.
Background Patients with hypertension may be vulnerable to vascular Chlamydia pneumoniae and/or cytomegalovirus (CMV) infection because
of increased expression of adhesion molecules.
Objective To determine whether C pneumoniae or CMV is
associated with the presence of atherosclerotic lesions in hypertensive patients.
Methods Ninety-six angiographic studies on 100 consecutive patients with of
clinical signs or symptoms suggestive of renovascular hypertension were reviewed
for the presence or absence of atherosclerotic lesions at the level of the
renal arteries as well and abdominal aorta. Also, the presence of a hemodynamically
notable renal artery stenosis and antibodies to C pneumoniae (IgG and IgA) and CMV (IgG and IgM) was determined, and all classic
risk factors were recorded.
Results Atherosclerotic lesions were documented in 67 patients (70%), and in
49 patients (51%) such lesions were persent at the level of the renal artery.
In the univariate analysis, significant associations between IgG (odds ratio,
3.8; 95% confidence interval, 1.2-11.7; P = .02)
as well as IgA (odds ratio, 2.6; 95% confidence interval, 1.1-6.7; P = .03) antibodies to C pneumoniae and the
presence of atherosclerosis were found for both the aorta and the renal arteries.
Seroprevalence (IgG) to C pneumoniae in the 23 patients
with a hemodynamically notable renal artery stenosis was 100% and differed
(P = .01) from those without a notable renal artery
stenosis (78%). In the multivariate analysis, IgG seropositivity to C pneumoniae was significantly associated with atherosclerosis
(odds ratio, 6.0; 95% confidence interval, 1.33-27.5; P = .02), and age. There was no association between CMV seropositivity
and atherosclerosis.
Conclusion The presence of antibodies to C pneumoniae
was significantly associated with atherosclerosis and renovascular disease
in hypertensive patients in whom a renal artery stenosis was strongly suspected.
From the Cardiovascular Research Institute, Maastricht University,
Maastricht, the Netherlands, and the Departments of Medical Microbiology (Drs
van der Ven and Bruggeman), Internal Medicine (Ms Hommels and Drs Kroon and
de Leeuw), Clinical Epidemiology and Medical Technology Assessment (Dr Kessels),
and Radiology (Ms Flobbe and Dr Engelshoven), Academic Hospital Maastricht,
Maastricht.
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