Chlamydia pneumoniae, herpes simplex virus type 1, and cytomegalovirus and incident myocardial infarction and coronary heart disease death in older adults -: The Cardiovascular Health Study
Chlamydia pneumoniae, herpes simplex virus type 1, and cytomegalovirus and incident myocardial infarction and coronary heart disease death in older adults -: The Cardiovascular Health Study
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DOI：
10.1161/01.cir.102.19.2335
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发表时间：
2000-11-07
期刊：
影响因子：
37.8
通讯作者：
Kronmal, RA
中科院分区：
文献类型：
--
作者：
Siscovick, DS;Schwartz, SM;Kronmal, RA
背景 - 既往感染肺炎衣原体、单纯疱疹病毒 1 型 (HSV-1) 和巨细胞病毒 (CMV) 的血清学证据是否与心肌梗死 (MI) 和冠心病 (CHD) 死亡相关仍然存在争议。方法和结果 - 我们在心血管健康研究的参与者中进行了一项巢式病例对照研究，这是一项年龄大于或等于 65 岁人群的队列研究。病例经历了心梗和冠心病死亡事件 (n=213)。对照受试者按年龄、性别、诊所、入组年份和抽血月份与病例进行匹配 (n=405)。分析血清中针对肺炎衣原体、HSV-1 和 CMV 的 IgG 抗体。调整其他危险因素后，MI和CHD死亡风险与HSV-1 IgG抗体的存在相关（优势比[OR] 2.0，95% CI 1.1至3.6），但与肺炎衣原体IgG抗体（OR 1.1，95% CI 0.7至1.8）或CMV（OR 1.2，95% CI 0.7至1.8）或CMV（OR 1.2，95% CI 0.7至3.6）的存在无关。 1.9）。尽管与低至中度肺炎衣原体抗体滴度（小于或等于 1:512）几乎没有关联，但高滴度 (1:1024) 肺炎衣原体抗体与风险增加相关（OR 2.2，95% CI 1.1 至 4.4）。结论 - 在老年人中，HSV-1 IgG 抗体的存在与 MI 和 CHD 死亡风险增加 2 倍相关。对于肺炎衣原体，只有高滴度 IgG 抗体与 MI 和 CHD 死亡风险增加相关。巨细胞病毒 IgG 抗体的存在与老年人的风险无关。
Background-Whether serological evidence of prior infection with Chlamydia pneumoniae, herpes simplex virus type 1 (HSV-1), and cytomegalovirus (CMV) is associated with myocardial infarction (MI) and coronary heart disease (CHD) death remains a source of controversy.Methods and Results-We conducted a nested case-control study among participants in the Cardiovascular Health Study, a cohort study of persons aged greater than or equal to 65 years. Cases experienced an incident MI and CHD death (n=213). Control subjects were matched to cases by age, sex, clinic, year of enrollment, and month of blood draw (n=405). Serum was analyzed for IgG antibodies to C pneumoniae, HSV-1, and CMV. After adjustment for other risk factors, the risk of MI and CHD death was associated with the presence of IgG antibodies to HSV-1 (odds ratio [OR] 2.0, 95% CI 1.1 to 3.6) but was not associated with the presence of IgG antibodies to either C pneumoniae (OR 1.1, 95% CI 0.7 to 1.8) or CMV (OR 1.2, 95% CI 0.7 to 1.9). Although there was little association with low to moderate C pneumoniae antibody titers (less than or equal to1:512), high-titer (1:1024) C pneumoniae antibody was associated with an increased risk (OR 2.2, 95% CI 1.1 to 4.4).Conclusions-Among older adults, the presence of IgG antibodies to HSV-1 was associated with a 2-fold increase in the risk of incident MI and CHD death. For C pneumoniae, only high-titer IgG antibodies were associated with an increased risk of MI and CHD death. The presence of IgG antibodies to CMV was not associated with risk among the elderly.