Chlamydia pneumoniae and cardiovascular disease.

Chlamydia pneumoniae has been detected in atherosclerotic plaques, while seropositivity to this organism confers a slightly increased risk of coronary events. However, no aetiological link has been established; a major difficulty when investigating this link is the lack of a gold standard for diagnosing chronic vessel infection. The outcomes of case-control studies and prospective trials of macrolides in treatment and prevention of cardiovascular disease have been ambiguous but suggest a short-term preventive effect. Whether this is due to the antimicrobial or anti-inflammatory activity of the macrolides is unknown. Larger and longer prospective trials currently under way may provide better insight into the association of C. pneumoniae with cardiovascular disease. At present, there is no justification for treating cardiovascular disease with antibiotics.

[Atherosclerosis and Chlamydia pneumoniae]. / Aterosklerose og Chlamydia pneumoniae.

Chlamydia pneumoniae could be associated with the risk of developing atherosclerosis and an increased risk of thromboembolic complications. However, the evidence of an association seems to be declining and there is no evidence of causality. The effect of antibiotic treatment in cardiovascular disease has been explored in epidemiologic studies and in randomised controlled trials. Data suggest a protective but short-lasting effect of macrolide antibiotics on cardiovascular disease. The effect could be the result of anti-bacterial as well as anti-inflammatory properties. Ongoing larger and longer lasting treatment trials could provide better measures of the effects of antibiotic treatment, although they will not clarify the role of C. pneumoniae. Currently, there is no indication for treating cardiovascular disease with antibiotics.