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(Stroke. 2000;31:1526.)
© 2000 American Heart Association, Inc.

Original Contributions

Chlamydia pneumoniae Seropositivity Is Associated With Carotid Artery Intima-Media Thickness

Caroline Schmidt, BSc; Johannes Hulthe, MD, PhD; John Wikstrand, MD, PhD; Håkan Gnarpe, MD, PhD; Judy Gnarpe, PhD; Stefan Agewall, MD, PhD Björn Fagerberg, MD, PhD

From the Department of Medicine, Sahlgrenska University Hospital/Sahlgrenska, Gothenburg (S.A., B.F.), the Department of Clinical Microbiology, Gävle Central Hospital, Gävle (H.G., J.G.), Institute of Medical Sciences, University of Uppsala, Uppsala (H.G.), and the Wallenberg Laboratory for Cardiovascular Research, Sahlgrenska University Hospital/Sahlgrenska, Göteborg University, Gothenburg, Sweden (C.S., J.H., J.W.).

Correspondence to Björn Fagerberg, Wallenberg Laboratory, SU/Sahlgrenska, S-413 45 Gothenburg, Sweden. E-mail Bjorn.Fagerberg{at}mailer.medfak.gu.se

Background and Purpose—Infection may both augment the atherosclerotic process and contribute to later manifestations of overt clinical disease. Chlamydia pneumoniae elementary bodies have been detected in atherosclerotic lesions. The aim of the present study was to investigate whether elevated titers of antibodies and circulating immune complexes to C pneumoniae were associated with ultrasound findings indicating presence of atherosclerosis in the carotid artery.

Methods—Serum titers of antibodies to C pneumoniae (IgM, IgA, IgG, and circulating immune complex) were related to intima-media thickness (IMT) and plaque status measured by B-mode ultrasound in the carotid artery in 113 men with treated hypertension and at least 1 of the following risk factors: hypercholesterolemia, smoking, or diabetes.

Results—Any of the titers was elevated in 56 (50%) men, and common carotid artery IMT was thicker in this group compared with the 57 men without any elevated titers (1.00 versus 0.92 mm, P<0.05). There were no accompanying differences in blood pressure, lipid levels, blood glucose, or smoking. Elevation of separate antibody types and circulation immune complex were also associated with increased IMT. In the latter group, systolic blood pressure was higher among seropositive patients compared with those who had no circulating immune complex. Seropositivity was not related to plaque status.

Conclusions—Seropositivity for C pneumoniae was associated with an increased intima-media thickness in the common carotid artery but not plaque status in hypertensive men at high risk for cardiovascular disease.

Key Words: carotid arteries • chlamydia

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