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(Stroke. 2000;31:2517-b.)
© 2000 American Heart Association, Inc.

Letters to the Editor

Chlamydia pneumoniae Infection and PFO-Associated Ischemic Stroke

Maurizia Rasura, MD Alexia Anzini, MD

Department of Neurological Sciences

M. Teresa Mascellino, MD

Department of Tropical and Infectious Diseases, University of Rome "La Sapienza", Rome, Italy

To the Editor:

Ischemic stroke in young adults is a topic that has received increasing attention in recent years and has been accompanied by descriptions of case series in which the relative frequencies of risk factors and presumed etiology are assessed.¹ A number of epidemiological and pathogenic studies have been published on the association between Chlamydia pneumoniae infection and ischemic stroke. The results are, however, controversial. These studies show a high degree of heterogeneity in the selection of patients and controls and in the interpretation of serological results.^{2 3} Wimmer et al⁴ studied a series of stroke patients aged <50 years. They concluded that chronic C pneumoniae infection is associated with an increased risk of stroke and TIA but were unable to detect any correlation between antibody titers and etiologic stroke subtypes.

Our study was designed to evaluate the potential role of C pneumoniae infection in specific etiologic subtypes of stroke in young patients. In our consecutive series of 101 patients with ischemic stroke, aged <46 completed years, and 101 matched controls, we evaluated C pneumoniae IgG and IgM antibodies by means of the microimmunofluorescence method. When the study was planned, the detection of IgA was not yet available. There was a statistically significant difference between the 2 groups with regard to the frequency of active chronic C pneumoniae infection (IgG 1:512) (25.7% versus 7.8%, P<0.05). After adjustment for cerebrovascular risk factors, the OR for inactive chronic infection (IgG 1:256) was 1.3 (95% CI 0.6 to 3.2), whereas that for . . . [Full Text of this Article]

Gregory Y.H. Lip, MD, FACC Sridhar Kamath, MRCP

Haemostasis Thrombosis and Vascular Biology Unit, University Department of Medicine, City Hospital, Birmingham, England