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(Arteriosclerosis, Thrombosis, and Vascular Biology. 2005;25:386.)
© 2005 American Heart Association, Inc.

Atherosclerosis and Lipoproteins

Asymptomatic Carotid Atherosclerosis Is Associated With Circulating Chlamydia pneumoniae DNA in Younger Normotensive Subjects in a General Population Survey

Rolf Mitusch; Jan Luedemann; William G. Wood; Klaus Berger; Ulf Schminke; Matthias Suter; Christof Kessler; Ulrich John; Jan Rupp; Michael Kentsch; Matthias Maass

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.

Correspondence to Rolf Mitusch, MD, Medical Department, Hanse-Hospital Stralsund, Teaching Hospital of the Ernst-Moritz-Arndt-University of Greifswald, Post Box 2341, D-18410 Stralsund, Germany. 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.

C pneumoniae has been implicated in atherogenesis. We determined the association of chlamydial DNA in peripheral blood mononuclear cells with the carotid intima-media thickness from 1032 healthy subjects from a general population survey. A stratified group interaction analysis revealed an independent association in normotensive subjects and those <70 years old.

Key Words: Chlamydia pneumoniae • infection • atherosclerosis • intima-media thickness

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