Jl. Mehta et al., INTERACTIVE ROLE OF INFECTION, INFLAMMATION AND TRADITIONAL RISK-FACTORS IN ATHEROSCLEROSIS AND CORONARY-ARTERY DISEASE, Journal of the American College of Cardiology, 31(6), 1998, pp. 1217-1225
Although first suggested at the turn of the 20th century, there is a r
enewed interest in the infectious theory of atherosclerosis. Studies d
one in many laboratories around the world over the past several years
have shown an association between markers of inflammation and coronary
atherosclerosis with an exacerbation of the inflammatory process duri
ng acute myocardial ischemia, particularly in the early stages of repe
rfusion, It is also being recognized that the traditional risk factors
, such as smoking, dyslipidemia, hypertension and diabetes mellitus, d
o not explain the presence of coronary atherosclerosis in a large prop
ortion of patients. We believe that in certain genetically susceptible
people, infection with very common organisms, such as Chlamydia pneum
oniae or cytomegalovirus, may lead to a localized infection and a chro
nic inflammatory reaction. Persistence of infection may relate to the
degree of inflammation and severity of atherosclerosis. Early trials w
ith appropriate antibiotic agents in some patients with a recent histo
ry of acute myocardial infarction have led to very salutary results. I
f patients with an infectious basis of atherosclerosis can be identifi
ed, a therapy directed at eradication of the offending organism may be
appropriate.