Association of serology with the endovascular presence of Chlamydia pneumoniae and cytomegalovirus in coronary artery and vein graft disease

• Published in: Circulation (New York, N.Y.) N.Y.), 2000-01, Vol.101 (2), p.137-141
• Main Authors: BARTELS, C, MAASS, M, BEIN, G, BRILL, N, BECHTEL, J. F. M, LEYH, R, SIEVERS, H.-H
• Format: Article
• Language: English
• Subjects: Aged; Antibodies, Bacterial - analysis; Antibodies, Viral - analysis; Biological and medical sciences; Blood Vessel Prosthesis; Chlamydophila pneumoniae - immunology; Chlamydophila pneumoniae - isolation & purification; Coronary Vessels - immunology; Coronary Vessels - microbiology; Coronary Vessels - surgery; Coronary Vessels - virology; Cytomegalovirus - immunology; Cytomegalovirus - isolation & purification; Female; Graft Occlusion, Vascular - immunology; Humans; Immunoglobulin G - analysis; Male; Medical sciences; Middle Aged; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the heart
• ISSN: 0009-7322; 1524-4539
• DOI: 10.1161/01.CIR.101.2.137

Chemotherapeutic treatment for patients with symptomatic coronary artery disease to reduce cardiovascular events may be initiated in response to elevated antibody titers against Chlamydia pneumoniae or cytomegalovirus. How antibody titers are associated with the endovascular presence of these microorganisms is still unclear. Antibody titers against C pneumoniae (microimmunofluorescence) and cytomegalovirus (ELISA) in patients undergoing primary (coronary desobliterates, n=80) or repeated CABG (occluded vein grafts, n=45) were correlated with the endovascular presence of the 2 microorganisms. C pneumoniae was detected by means of a nested polymerase chain reaction (PCR) and by culturing. Both conventional PCR and quantitative PCR were applied for detection of cytomegalovirus. C pneumoniae (PCR/culture) was detected in 19/9% (15/80 and 7/80) of coronary desobliterates and in 18/11% (8/45 and 5/45) of occluded vein grafts. There was no statistical evidence that IgG values differed between patients with or without C pneumoniae detection who were undergoing primary CABG. In contrast, repeated-CABG patients with a positive PCR (P=0.0027) or C pneumoniae culture (P=0.0018) had distinctly elevated IgG titers compared with patients in whom C pneumoniae was not detected. Cytomegalovirus could not be detected in the examined specimens. Cytomegalovirus infection does not seem to be associated with advanced coronary artery lesions. C pneumoniae antibody titers are not associated with the endovascular presence of C pneumoniae in patients with coronary artery disease. The observed strong association between elevated IgG titers and the detection of C pneumoniae in occluded vein grafts warrants further investigation.