INCREASED FIBRINOGEN LEVELS ARE ASSOCIATED WITH PERSISTENT CHLAMYDIA-PNEUMONIAE INFECTION IN UNSTABLE CORONARY-ARTERY DISEASE

Aim Increased levels of acute phase proteins, e.g. fibrinogen, are rel ated to a poor outcome in unstable coronary artery disease, but the ca use of inflammation is unknown. We therefore investigated the prevalen ce of persistent Chlamydia pneumoniae infection, and its relationship to inflammation in this condition. Methods and Results In 256 patients participating in the FRISC trial, evaluating the effects of daltepari n (a low molecular weight heparin) in unstable angina or non-Q wave my ocardial infarction, Chlamydia pneumoniae IgA antibody titres and leve ls of fibrinogen, C-reactive protein and troponin T were determined at inclusion. Increased C. pneumoniae IgA antibody titres were significa ntly more common in the patients (36%) than in a reference population of similar age (19%); P<0.001. Raised titres were associated with male gander, increasing age, smoking, and elevated concentrations of fibri nogen, C-reactive protein and troponin T. The association between pers istent C. pneumoniae infection and increased fibrinogen levels was ind ependent of other risk factors evaluated in multivariate analysis (P=0 .009). Conclusion Persistent C. pneumoniae infection is common in unst able coronary artery disease. The independent association between incr eased C. pneumoniae IgA antibody titres and fibrinogen levels indicate s that chronic infection could be of importance for disease activity.