The Role of Chlamydia Pneumoniae in the Pathogenesis of Coronary Heart Disease

Abstract

Objective: To review the role of Chlamydia pneumoniae in the pathogenesis of coronary heart disease (CHD). Data Sources: Articles indexed in MEDLINE from 1966 to April 1998 as well as references identified in these articles were searched. Data Extraction: Studies investigating seroepidemiologic and pathologic evidence for an association of C. pneumoniae with CHD and randomized clinical trials evaluating the effectiveness of antibiotic therapy on cardiovascular outcomes are presented. Data Synthesis: Seroepidemiologic and pathologic studies provide circumstantial evidence of an association between C. pneumoniae and CHD. Results of initial small trials suggest a reduction in CHD events in patients treated with macrolide antibiotics. Conclusions: Direct evidence implicating chlamydial infection in CHD is lacking. Formal recommendations for antimicrobial therapy should not be made until results of additional clinical trials are available.