Affiliation:
1. From the Department of Pathology and Molecular Medicine, McMaster University, Hamilton, Ontario, Canada (M.S., M.M.); the Department of Medicine, McMaster University, Hamilton, Ontario, Canada (M.S., E.L., M.M., S.Y.); the Department of Medical Microbiology and Immunology, University of Alberta, Edmonton, Alberta, Canada (J.G.); the Department of Clinical Epidemiology and Biostatistics, Hamilton, Ontario, Canada (Q.Y., S.Y.); the Institute of Medical Sciences, Uppsala University, Uppsala, Sweden (H...
Abstract
Background—
Limited prospective epidemiological data are available on the relation between exposure to
Chlamydia pneumoniae
,
Helicobacter pylori
, cytomegalovirus (CMV), and hepatitis A virus (HAV), individually or as a total pathogen score, and human cardiovascular (CV) disease.
Methods and Results—
We analyzed enrollment sera from 3168 Canadian patients in the Heart Outcomes Prevention Evaluation (HOPE) study for antibodies to
C pneumoniae
,
H pylori
, CMV, and HAV and measured the relation between serostatus and 494 adjudicated trial outcomes of myocardial infarction, stroke, or CV death over 4.5 years of follow-up. CV events were associated with CMV serostatus (covariate-adjusted hazard ratio [HR], 1.24; 95% CI, 1.01, 1.53). Neither
C pneumoniae
IgG (adjusted HR, 0.87; 95% CI, 0.68, 1.10),
C pneumonia
IgA (adjusted HR, 1.10; 95% CI, 0.90, 1.34),
H pylori
IgG (HR, 0.99; 95% CI, 0.82, 1.19), nor HAV IgG (HR, 1.01; 95% CI, 0.83, 1.24) predicted CV events. Total pathogen score was associated with CV events (adjusted HR for 4 versus 1 or 0=1.41; 95% CI, 1.02, 1.96).
Conclusions—
Exposure to CMV but not to
C pneumoniae
,
H pylori
, or HAV was associated with a slight excess risk of subsequent myocardial infarction, stroke, or CV death in HOPE study patients, and total pathogen score based on these infections predicted a small increased hazard of CV events.
Publisher
Ovid Technologies (Wolters Kluwer Health)
Subject
Physiology (medical),Cardiology and Cardiovascular Medicine
Cited by
126 articles.
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