Chlamydia pneumoniae IgG and IgA antibody titers and prognosis in patients with coronary heart disease: results from the CLARICOR trial.

Abstract

The association observed between coronary heart disease (CHD) and Chlamydia (Chlamydophila) pneumoniae antibodies prompted, during the 1990s, several primary and secondary prevention trials with various antibiotics. In our CLARICOR trial, a randomized placebo-controlled trial in 4372 patients with stable CHD, a brief clarithromycin regimen was followed, unexpectedly, by increased long-term mortality. We now compare C. pneumoniae antibody levels at entry with population levels, with the patients' individual histories, and with their subsequent outcomes. IgG antibody levels were somewhat raised, but elevated IgA and IgG titers were unrelated to entry data (including prior acute myocardial infarction), except for an association with smoking and with not using statins. Hazards of mortality and of other outcomes tended to slightly increase with IgA and decrease with IgG titers, but the unfavorable clarithromycin effect was unrelated to antibody levels and remains unexplained. Smoking-related lung disease probably underlies the link between heart disease and increased IgG titers.

• Authors: Jørgen Hilden, Inga Lind, Hans Jørn Kolmos, Bodil Als-Nielsen, Morten Damgaard, Jørgen Fischer Hansen, Stig Hansen, Olav H Helø, Per Hildebrandt, Gorm Boje Jensen, Jens Kastrup, Erik Kjøller, Henrik Nielsen, Lars Petersen, Christian M Jespersen, Christian Gluud, CLARICOR Trial Group
• Journal: Diagnostic microbiology and infectious disease (Diagn Microbiol Infect Dis) Vol. 66 Issue 4 Pg. 385-92 (Apr 2010) ISSN: 1879-0070 [Electronic] United States
• PMID: 20226329 (Publication Type: Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)
• Copyright: 2010 Elsevier Inc. All rights reserved.

Chemical References

• Anti-Bacterial Agents
• Antibodies, Bacterial
• Immunoglobulin A
• Immunoglobulin G
• Placebos
• Clarithromycin

Topics

• Aged
• Anti-Bacterial Agents (therapeutic use)
• Antibodies, Bacterial (blood)
• Chlamydophila Infections (complications, drug therapy, immunology, mortality)
• Chlamydophila pneumoniae (drug effects, immunology)
• Clarithromycin (therapeutic use)
• Coronary Disease (complications, mortality)
• Female
• Humans
• Immunoglobulin A (blood)
• Immunoglobulin G (blood)
• Male
• Middle Aged
• Placebos (administration & dosage)
• Prognosis
• Risk Factors