The relationship between Chlamydophila pneumoniae IgG titer and coronary atherosclerosis

Background: The role of Chlamydophila pneumoniae (CP) in the progression of atherosclerosis is controversial. Also no sufficient angiographic study is available about the impact of CP infection on severity and intensity of coronary atherosclerosis. We investigated the relation between CP IgG antibody titers and severity and intensity of coronary atherosclerosis Methods: The study population consisted of 516 consecutive patients who underwent a coronary angiography. The group included 353 patients who had coronary artery disease; a control group included 163 subjects with angiographically proven normal coronary arteries. Chlamydophila pneumoniae IgG antibody titers were measured by an enzyme immunoassay method in all patients. Gensini scores and extent scores were used to evaluate the angiographic extent and severity of atherosclerosis. Results: The mean value of IgG antibody titer was 44.3 &#177; 28.8 IU/mL in the patients and 39.8 &#177; 27.4 IU/mL in the control group (p = 0.14). There was no statistically significant correlation between the Gensini scores, extent scores and CP IgG titers (Gensini score: r = +0.103, p = 0.07, extent score: r = +0.110, p = 0.31). When we grouped the patients as high (> 50 IU/mL) and low (< 50 IU/mL) IgG antibody titers, the number of diseased coronary arteries was higher in patients with high IgG antibody titers (respectively: 2.6 &#177; 1.1 vs. 2.2 &#177; 0.8, p = 0.01). While the Gensini score was significantly higher in patients with high IgG antibody titers (7.5 &#177; 4.0 vs. 6.17 &#177; 4.0, p = 0.01), the extent score did not change with IgG titers (29.8 &#177; 15.9 vs. 25.8 &#177; 15.4, p = 0.08). Conclusions: In our study, we investigated the relation between CP infection and coronary atherosclerosis and found that CP IgG antibody titers are associated with the severity of coronary stenosis at higher antibody levels. However, there is no association between CP antibody titers and clinical presentation of coronary artery disease. We suggest that CP has limited effect on coronary atherosclerosis. (Cardiol J 2008; 15: 245-251

Fistula between left internal mammary artery graft and pulmonary vasculature after coronary bypass grafting Koroner baypas sonrasi sol i̇ç meme arter grefti ve akciǧer damarlari arasinda fistül oluşumu

Left internal mammary artery (LIMA) is very commonly used conduit for coronary artery bypass grafting (CABG) due to its proven long term patency. The development of fistula between LIMA and pulmonary vasculature is a rare complication of this operation. Recurrent angina pectoris developed in a 73-year-old man 3 years after CABG. Coronary angiography revealed a fistulous connection between LIMA graft and the left pulmonary vasculature. Our patient was managed conservatively with acetylsalicylic acid, statin, nitrate, and angiotensin converting enzyme inhibitor. We report herein a case who developed LIMA to pulmonary vasculature fistula after the CABG

The relationship between Chlamydophila pneumoniae IgG titer and coronary atherosclerosis

Background: The role of Chlamydophila pneumoniae (CP) in the progression of atherosclerosis is controversial. Also no sufficient angiographic study is available about the impact of CP infection on severity and intensity of coronary atherosclerosis. We investigated the relation between CP IgG antibody titers and severity and intensity of coronary atherosclerosis Methods: The study population consisted of 516 consecutive patients who underwent a coronary angiography. The group included 353 patients who had coronary artery disease; a control group included 163 subjects with angiographically proven normal coronary arteries. Chlamydophila pneumoniae IgG antibody titers were measured by an enzyme immunoassay method in all patients. Gensini scores and extent scores were used to evaluate the angiographic extent and severity of atherosclerosis. Results: The mean value of IgG antibody titer was 44.3 ± 28.8 IU/ mL in the patients and 39.8±27.4 IU/mL in the control group (p = 0.14). There was no statistically significant correlation between the Gensini scores, extent scores and CP IgG titers (Gensini score: r = +0.103, p = 0.07, extent score: r = +0.110, p = 0.31). When we grouped the patients as high (> 50 IU/mL) and low (< 50 IU/mL) IgG antibody titers, the number of diseased coronary arteries was higher in patients with high IgG antibody titers (respectively: 2.6 ± 1.1 vs. 2.2 ± 0.8, p = 0.01). While the Gensini score was significantly higher in patients with high IgG antibody titers (7.5 ± 4.0 vs. 6.17 ± 4.0, p = 0.01), the extent score did not change with IgG titers (29.8 ± 15.9 vs. 25.8 ± 15.4, p = 0.08). Conclusions: In our study, we investigated the relation between CP infection and coronary atherosclerosis and found that CP IgG antibody titers are associated with the severity of coronary stenosis at higher antibody levels. However, there is no association between CP antibody titers and clinical presentation of coronary artery disease. We suggest that CP has limited effect on coronary atherosclerosis. Copyright © 2008 Via Medica