on November 18, 2004
Published online before print November 18, 2004, doi: 10.1161/01.ATV.0000151284.49967.a7
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Submitted on March 7, 2004
Accepted on October 28, 2004
Asymptomatic Carotid Atherosclerosis Is Associated With Circulating Chlamydia pneumoniae DNA in Younger Normotensive Subjects in a General Population Survey
Rolf Mitusch *;
From the Medical Department, Hanse-Hospital Stralsund, Teaching Hospital of the Ernst-Moritz-Arndt-University of Greifswald (R.M., M.S.), Institute of Clinical Chemistry and Laboratory Medicine (J.L.), Department of Neurology (U.S., C.K.), and Institute of Epidemiology and Social Medicine (U.J.), Ernst-Moritz-Arndt-University of Greifswald, Reference Method Laboratories, Institute for Standardization and Documentation in the Medical Laboratory (INSTAND), Duesseldorf (W.G.W.), Institute of Epidemiology and Social Medicine, University of Muenster (K.B.), Institute of Medical Microbiology and Hygiene, University of Lubeck (M.M., J.R.), and Hospital Itzehoe, Teaching Hospital of the University of Lubeck, Itzehoe (M.K.), Germany.
* To whom correspondence should be addressed. E-mail: mitusch{at}uni-greifswald.de.
Objective--Chlamydia pneumoniae infection has been associated with atherosclerosis, but serodiagnosis is unreliable in predicting vascular infection. Direct detection of circulating chlamydial DNA in peripheral blood mononuclear cells (PBMCs) was thus evaluated as a marker for cardiovascular risk in a general population survey using the common carotid intima-media thickness (IMT) as surrogate marker of asymptomatic atherosclerosis.
Methods and Results--C pneumoniae DNA in PBMCs was determined by nested polymerase chain reaction and associated with IMT for 1032 healthy participants of a general population survey who were within the highest or lowest IMT distribution quartile. C pneumoniae DNA was more prevalent in those with increased IMT (13.4% versus 10.7%), but this was not significant in univariate and of borderline significance in multivariate analysis. Testing for potential effect modifications by known strong determinants of an increased IMT in group interaction analysis revealed an independent association between C pneumoniae DNA and IMT in normotensive subjects (odds ratio [OR], 2.06; 95% CI, 1.05 to 4.03; P=0.04) and in those <70 years old (OR, 1.84; 95% CI, 1.06 to 3.19; P=0.03).
Conclusions--Asymptomatic atherosclerosis is associated with circulating C pneumoniae DNA independently of classical cardiovascular risk factors in normotensive subjects and those <70 years old.
Key words: Chlamydia pneumoniae • infection • atherosclerosis • intima-media-thickness
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