Seroprevalence of IgG antibodies to Chlamydia pneumoniae and Helicobacter pylori among coronary heart disease patients and normal individuals in South Indian population.

In recent years, the role of infectious agents in the aetiology of atherosclerotic disease has come to the forefront. In the present study, seroprevalence (IgG) of chlamydia pneumoniae and helicobacter pylori in patients with atherosclerotic coronary heart disease was compared to normal healthy adults. Out of a total of 117 patients 101 had unstable angina (UA) and 16 had chronic stable angina (CSA). C. pneumoniae seropositivity was found in 66% of patients with UA and 94% of CSA patients. The corresponding figures for H. pylori were 58% and 56% respectively. In comparison, 81% of healthy adults were seropositive for C. pneumoniae and 53% for H.pylori. No significant association was found between CHD and the infectious agents. However, this study has revealed a high infection by C. pneumoniae as well as H.pylori in this part of India.

Roxithromycin in prevention of acute coronary syndrome associated with Chlamydia pneumoniae infection: a randomized placebo controlled trial.

The role of Chlamydia pneumoniae infection in precipitating acute coronary syndrome (ACS) is unclear. Some studies have indicated that intervention with macrolide antibiotics might reduce coronary events in patients with ACS. A double blind, randomized, placebo-control trial was conducted on 84 ACS patients. Patients were randomized to 30 days of treatment with roxithromycin (150 mg, twice daily) or matching placebo. The follow-up period was 90 days, and the primary clinical end point included cardiovascular death, unplanned revascularization and recurrent angina/MI. Anti-C. pneumoniae IgG positive in 24 of 43 (55.8%) patients in the roxithromycin group and 23 of 41 (56.1%) patients in the placebo group. Anti-C. pneumoniae IgA positive in 20 of 43 (46.5%) patients in the roxithromycin group and 13 of 41 (31.7%) patients in the placebo group. Thirty-three cardiac events occurred (2 cardiovascular deaths, 9 CABG, 12 PTCA and 10 recurrent angina/MI) with 17 events in the roxithromycin group and 16 events in the placebo group. There was no significant difference of cardiac events between the roxithromycin and placebo groups. The present study suggests that antibiotic therapy with roxithromycin is not associated with reduction of cardiac events as reported by other investigators. However, therapeutic interventions may need to be specifically targeted to a group of patients who are confirmed with chronic C. pneumoniae infection.