Previous cytomegalovirus or Chlamydia pneumoniae infection and risk of restenosis after percutaneous transluminal coronary angioplasty

Carlsson, J.; Miketic, Sinisa; Mueller, Karl-Heinz; Brom, J.; Ross, Rolf; Essen, R. von; Tebbe, Ulrich

doi:10.1016/s0140-6736(05)63456-3

Cited by 26 publications

(16 citation statements)

References 5 publications

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“…Our results are in agreement with another study after balloon angioplasty,7 9 12 but contrast with those observed after directional atherectomy 6. One possible explanation for this discrepancy is the varying degree of vascular injury caused by each of the revascularisation techniques.…”

Section: Discussionsupporting

confidence: 89%

“…It has been shown that there is a link between previous cytomegalovirus infection and restenosis after atherectomy,6 but this has not been confirmed in the setting of balloon angioplasty 7-9. Similarly, a relation between C pneumoniae antibodies and balloon angioplasty has been observed,10 but again the evidence for a link with the process of restenosis remains controversial 911 12 …”

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confidence: 99%

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Cytomegalovirus, Chlamydia pneumoniae, and Helicobacter pylori IgG antibodies and restenosis after stent implantation: an angiographic and intravascular ultrasound study

Schiele

Mk²,

Seronde³

et al. 2001

Heart

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Objective-To determine the impact of previous infection with cytomegalovirus, Chlamydia pneumoniae, and Helicobacter pylori on neointimal proliferation after coronary angioplasty with stent implantation. Design-The study population was made up of 180 patients who had stent implantation in a native coronary artery with systematic angiographic and intravascular ultrasound (IVUS) follow up at six months. Quantitative coronary angiography was used to assess the late lumen loss. The mean area of neointimal tissue within the stent and the ratio of neointimal tissue to stent area were assessed from IVUS images. Previous cytomegalovirus, C pneumoniae, and H pylori infection was identified by IgG antibody determination. Results-Previous cytomegalovirus infection was detected in 50% of the population, previous C pneumoniae in 18%, and previous H pylori in 33%. Mean (SD) reference diameter was 2.94 (0.48) mm and mean minimum lumen diameter after stent implantation was 2.45 (0.42) mm. At six months, the mean late loss was 0.74 (0.50) mm, the mean neointimal tissue area was 3.8 (1.7) mm 2 , and the average ratio of neointimal tissue area to stent area was 45 (18)%. None of these variables of restenosis was linked to any of the three infectious agents. By multivariate analysis, lesion length was the variable best correlated with mean neointimal tissue area, the ratio of neointimal tissue to stent area, and late loss, explaining respectively 31%, 39%, and 8% of their variability. Conclusions-Previous infection with cytomegalovirus, C pneumoniae, or H pylori was not a contributing factor in the process of restenosis after stent implantation. (Heart 2001;85:304-311)

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Section: Discussionsupporting

confidence: 89%

mentioning

confidence: 99%

Cytomegalovirus, Chlamydia pneumoniae, and Helicobacter pylori IgG antibodies and restenosis after stent implantation: an angiographic and intravascular ultrasound study

Schiele

Mk²,

Seronde³

et al. 2001

Heart

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“…Comparable results were reported by Carlsson et al [22] who examined patients before and after a PTCA for IgG antibodies to CMV and C. pneumoniae by ELISA.They could not show a relation between the serological state of a CMV or C. pneumoniae infection and the incidence of restenosis. Comparable results were reported by Carlsson et al [22] who examined patients before and after a PTCA for IgG antibodies to CMV and C. pneumoniae by ELISA.They could not show a relation between the serological state of a CMV or C. pneumoniae infection and the incidence of restenosis.…”

Section: Discussionsupporting

confidence: 61%

Chlamydia pneumoniae Infection and Restenosis in Patients with Coronary Heart Disease

et al. 2003

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Background:The aim of this study was to establish whether Chlamydia pneumoniae is implicated in the development of restenosis in patients with coronary heart disease (CHD) after percutaneous transluminal coronary angioplasty (PTCA). Patients and Methods: 67 patients were selected for study after they underwent control angiography after PTCA. Sera were tested for anti-chlamydial antibodies with a genusspecific ELISA and a species-specific microimmunofluorescence test (MIFT). Oropharyngeal specimens were examined for the presence of antigen with a Chlamydia immunofluorescence test (IFT), C. pneumoniae IFT and semi-nested PCR. In addition, anamnestic findings were also included. To determine the general level of antibodies, an age-and sexmatched control group of 180 persons was also examined for Chlamydia and C. pneumoniae serology. Results: Coronary angiography revealed that 31 of the 67 patients had developed a restenosis. There was no significant correlation between serological and angiographic findings. However, the MIFT showed a higher positive rate, especially in IgA, in the restenosis group. C. pneumoniae was detected in the oropharynx by PCR and/or IFT in 20.8% and 16.0% of the cases in patients with and without a restenosis. PCR found more C. pneumoniae-positive cases in the restenosis patients than IFT. No association was found between the detection of Chlamydia antigen and serology. The women with restenosis were more frequently smokers (p = 0.012). Men with restenosis were significantly older (p = 0.015). C. pneumoniae serology based on the rELISA or the MIFT did not show any correlation with restenosis. Conclusion: No evidence was found to suggest that positive C. pneumoniae serology is a risk factor for the development of restenosis. However, whether the species-specific serological test, especially for IgA-antibodies, and the detection of C. pneumoniae in oropharyngeal specimens by PCR might be reliable diagnostic markers in these cases remains to be determined.

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“…CMV infection and tumour suppresser protein p53 can be found in restenosis lesions [7]. Positive CMV serology was also a strong predictor of restenosis in the prospective studies of Zhou [8] and Neumann [9]; however, lack of association has also been reported [10]. Chlamydia pneumoniae has been shown to be associated with arterial pathology in several studies.…”

Section: Discussionmentioning

confidence: 99%

Chlamydia pneumoniae and luminal narrowing after coronary angioplasty

Mattila

Juvonen

Kotamäki

et al. 2001

Journal of Internal Medicine

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Abstract. Mattila KJ, Juvonen JT, Kotama Èki MK, Saikku PA (Helsinki University Hospital, Helsinki; Kainuu Central Hospital, Kajaani, and National Public Health Institute, Oulu, Finland). Chlamydia pneumoniae and luminal narrowing after coronary angioplasty. J Intern Med 2001; 250: 67±71.Objectives. Numerous studies have linked Chlamydia pneumoniae with atherosclerotic vessel disease and a trend for an association of the bacteria with restenosis after percutaneous transluminae coronary angioplasty (PTCA) has also been observed. The aim of this study was to assess the role of Chlamydia pneumoniae in the luminal narrowing taking place after PTCA. Design. A noninterventional 6-month follow-up study. Setting. A university hospital.Subjects. A total of 122 patients with angiographically proven coronary heart disease (CHD) referred for PTCA. Interventions. None. Main outcome measures. The degree of luminal narrowing in the coronary arteries following coronary angioplasty.Results. The levels of C. pneumoniae antibodies (IgG, IgA and IgM classes) and immune complexes were not associated with luminal narrowing after PTCA in multivariate analyses whilst smoking, plasma endothelin levels and diabetes were. The serologic parameters did not change during the follow up either. Conclusions. These results do not support a role for C. pneumoniae in luminal narrowing following PTCA.

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Previous cytomegalovirus or Chlamydia pneumoniae infection and risk of restenosis after percutaneous transluminal coronary angioplasty

Cited by 26 publications

References 5 publications

Cytomegalovirus, Chlamydia pneumoniae, and Helicobacter pylori IgG antibodies and restenosis after stent implantation: an angiographic and intravascular ultrasound study

Cytomegalovirus, Chlamydia pneumoniae, and Helicobacter pylori IgG antibodies and restenosis after stent implantation: an angiographic and intravascular ultrasound study

Chlamydia pneumoniae Infection and Restenosis in Patients with Coronary Heart Disease

Chlamydia pneumoniae and luminal narrowing after coronary angioplasty

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