ABSTRACT
<p><b>BACKGROUND</b>Although some certain infectious pathogens could be detected in the patients with coronary artery disease, the roles of these infectious factors in the development of coronary artery diseases remain largely unknown. Since the number of infectious pathogens has been argued to be relative to the coronary artery diseases, we therefore examined whether there is a link between the number of infections and the incidence of in-stent restenosis after stent implantation.</p><p><b>METHODS</b>One hundred and eighty-one patients were enrolled in this study. Infectious pathogens including serum anti-Chlymydia pneumoniae, cytomegalovirus, Helico pylori, human herpes simplex virus-1, human herpes simplex virus-2 antibodies and hepatitis B virus antigen were measured in all patients before coronary stent implantation. Coronary angiography was performed before, immediately after and 6 months after stent implantation.</p><p><b>RESULTS</b>Restenosis rate 6 months post stent implantation was similar in patients with low pathogen burden (< 3 pathogens, 33.3%) to those with high pathogen burden (> or = 3 pathogens, 29.1%).</p><p><b>CONCLUSIONS</b>Previous infections with Chlymydia pneumoniae, cytomegalovirus, Helico pylori, human herpes simplex virus-1, human herpes simplex virus-2 and hepatitis B virus do not contribute to the incidence of restenosis after stent implantation.</p>
Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Coronary Disease , Therapeutics , Coronary Restenosis , Infections , StentsABSTRACT
<p><b>OBJECTIVE</b>To evaluate the relationship between infection burden and coronary atherosclerosis and the plaque feature.</p><p><b>METHODS</b>One hundred and eighty two patients underwent coronary angiography in Zhongshan Hospital from 2002 - 2003. Atherosclerosis and vulnerable plaque were determined by intravascular ultrasound (IVUS). Seropositivity of cytomegalovirus, helicobacter pylori, chlamydia pneumonia, hepatitis B virus, EB virus, CoxB virus, influenza A virus, influenza B virus and mycobacterium tuberculosis were determined by ELISA. The serum hs-CRP was detected by Dade Behring prospect (Immuno-nehelomitery). Patients were divided into three groups according to the pathogen burden: group A, n <or= 3, group B, n = 4 - 5 and group C, n >or= 6.</p><p><b>RESULTS</b>The pathogen burden was independent of the C-reactive protein level. Increasing pathogen burden was significantly associated with increasing atherosclerosis risk, the prevalence of atherosclerosis was 44.4%, 70.6% and 76.7% in group A, B and C. The risk associated with elevated pathogen burden was much higher when CRP was also elevated (> 5.0 mg/L) (43.8%, 70.0%, 70.8%) vs (45.5%, 63.7%, 96.8%). The positively of vulnerable plaque increased significantly when the pathogen burden was high (n > 5) (33.3%, 32.4% and 51.7% P < 0.05).</p><p><b>CONCLUSION</b>Our data suggested that infection burden was associated with prevalence of coronary atherosclerosis, and it was particularly important when C-reactive protein was elevated. The high level infection burden could predict vulnerable plaque.</p>