Relation of Chlamydia pneumoniae infection in Taiwan to angiographically demonstrated coronary artery disease and to the presence of acute myocardialinfarction or unstable angina pectoris

Reports of the association of Chlamydia pneumoniae (C. pneumoniae) infectio n with coronary artery disease (CAD) are scarce in the Oriental population. We therefore conducted a case-control study to explore this issue in Taiwa n. There were 242 consecutive subjects (166 men and 76 women) who underwent cardiac catheterization at the Notional Taiwan University Hospital Cardiac Catheterization Laboratory. Patients with CAD (n = 156) had greater than o r equal to1 coronary artery lesion of >50% diameter stenosis on angiography . Controls (n = 86) had no demonstrable CAD angiographically. Antibodies to C. pneumoniae were tested by using an enzyme-linked immunosorbent assay. T he prevalence of antibodies to C. pneumoniae was as follows: immunoglobulin -G (IgG), 50% (122 of 242 patients); immunoglobulin-A (IgA), 72% (176 of 24 2 patients); and either IgG or IgA, 79% (192 of 242 patients). The odds rat io (OR) for CAD with either IgG or IgA was 1.4 (95% confidence interval [CI ] 0.7 to 2.7, p = 0.31). After adjusting for the known CAD risk factors, th e OR decreased to 0.8 (95% CI 0.3 to 2.1, p = 0.60). The OR for unstable an gina or acute myocardial infarction with the presence of either IgG or IgA was 0.5 (95% CI 0.2 to 1.1, p = 0.08) and 0.4 (95% CI 0.1 to 1.0, p = 0.049 ) after adjusting for other risk factors. These results suggest a high prev alence of C. pneumoniae infection in Taiwan. However, C. pneumoniae infecti on is not associated with angiographically documented CAD, and, in contrast , is a negative predictor for the development of acute coronary syndromes. (C)2001 by Excerpta Medica, Inc.