Coronary artery disease: an inflammatory or infectious process

It is well accepted that coronary artery disease is linked to an inflammato ry process. It is unknown which agents may cause or accelerate coronary art ery disease. An inflammation of the vessel wall may be caused by a number o f mechanisms such as accumulation of glycosylated proteins in diabetic pati ents, oxidised LDL in patients with hypercholesterolemia or infectious agen ts. Among the possible infectious agents Chlamydia pneumoniae is the most l ikely microorganism involved in atherosclerosis. The arguments in favour of Chlamydia pneumoniae result from seroepidemiologic studies and from detect ion of chlamydial DNA in atherosclerotic plaques by polymerase chain reacti on (PCR). In addition this microorganism is the only one that could be isol ated from atherosclerotic tissue. This review summarises the present unders tanding of the role of an inflammatory process in the development or progre ssion of coronary artery disease.