Predisposition to atherosclerosis by infections: role of endothelial dysfunction

Prasad, Abhiram, Zhu, Jianhui, Halcox, Julian P.J., Waclawiw, Myron, Epstein, Stephen E. and Quyyumi, Arshed A. 2002. Predisposition to atherosclerosis by infections: role of endothelial dysfunction. Circulation 106 (2) , pp. 184-190. 10.1161/01.cir.0000021125.83697.21

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Abstract

BACKGROUND: Several microorganisms have been implicated in the pathogenesis of atherosclerosis. We hypothesized that infections may predispose to atherosclerosis by inflicting endothelial injury. METHODS AND RESULTS: Of 375 patients undergoing coronary angiography, 218 had assessment of endothelial function using intracoronary acetylcholine (ACH) and of endothelium-independent function with sodium nitroprusside and adenosine. Immunoglobulin-G antibody titers to cytomegalovirus, Chlamydia pneumoniae, Helicobacter pylori, hepatitis A virus, and herpes simplex virus-1 were measured. Pathogen burden was defined as the number of positive antibodies. Although positive serology to individual pathogens tended to be associated with increased incidence of coronary arteriosclerosis (CAD), the pathogen burden correlated with the presence of CAD, even after adjustment for risk factors (OR 1.3; 95% CI, 1.05 to 1.6, P=0.018). Moreover, the severity of CAD was independently associated with the pathogen burden (P=0.001). Pathogen burden was an independent predictor of endothelial dysfunction, determined as the percent change in coronary vascular resistance in response to ACH (P=0.009) but not the responses to sodium nitroprusside or adenosine. Pathogen burden was also an independent determinant of endothelial function in the subgroup with angiographically normal coronary arteries. CONCLUSIONS: The immunoglobulin-G antibody response to multiple pathogens (pathogen burden) is an independent risk factor for endothelial dysfunction and the presence and severity of CAD. Endothelial dysfunction provides the crucial link by which pathogens may contribute to atherogenesis.

Item Type:	Article
Date Type:	Publication
Status:	Published
Schools:	Medicine
Subjects:	R Medicine > R Medicine (General)
Additional Information:	Comment in Shouldering the risk factor burden: infection, atherosclerosis, and the vascular endothelium. [Circulation. 2002] Full Text Sources HighWire Ovid Technologies, Inc. Other Literature Sources COS Scholar Universe Labome Researcher Resource - ExactAntigen/Labome Access more work from the authors - ResearchGate Medical Coronary Artery Disease - MedlinePlus Health Information Molecular Biology Databases Adenosine - HSDB Miscellaneous NCI CPTAC Assay Portal NCI CPTAC Assay Portal
Publisher:	American Heart Association
ISSN:	0009-7322
Date of Acceptance:	23 April 2002
Last Modified:	02 Nov 2015 11:40
URI:	https://orca.cardiff.ac.uk/id/eprint/71112

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