(Circulation. 1997;96:404-407.)
© 1997 American Heart Association, Inc.
Articles |
Elevated Chlamydia pneumoniae Antibodies, Cardiovascular Events, and Azithromycin in Male Survivors of Myocardial Infarction
From the Departments of Cardiological Sciences (S.G., E.W.L., J.C.K., A.J.C.), Virology (D.C.), and Medicine (M.A.M.), St George's Hospital Medical School, London, UK.
Correspondence to Dr Sandeep Gupta, BHF Cardiology Research Fellow, Department of Cardiological Sciences, St George's Hospital Medical School, Cranmer Terrace, Tooting, London SW17 ORE, UK.
 |
Abstract |
|---|
 Top Abstract IntroductionMethodsResultsDiscussionReferences |
|---|
Background The clinical significance of the association between elevated anti–Chlamydia pneumoniae (Cp) antibody titres and coronary heart disease (CHD) is unclear. We explored the relationship between antibodies against Cp and future cardiovascular events in male survivors of myocardial infarction (MI). The effect of azithromycin antibiotic therapy was assessed in a subgroup of post-MI patients.
Methods and Results We screened 220 consecutive male
survivors of MI for anti-Cp antibodies. Of these, 213 patients were
stratified into three groups: group Cp-ve (n=59), no detectable Cp
antibodies; group Cp-I (n=74), intermediate titres of 1/8 to 1/32
dilution; and group Cp+ve (n=80), seropositive at 
1/64 dilution.
Patients with persisting seropositivity of 1/64 were randomized to
either oral azithromycin (Cp+ve-A, 500 mg/d for 3 days [n=28] or 500
mg/d for 6 days [n=12]) or placebo (Cp+ve-P, n=20). Cp+ve-NR (n=20)
represented patients not recruited into the antibiotic
trial. The incidence of adverse cardiovascular events
(over a mean follow-up period of 18±4 months) was recorded and
shown to increase with increasing anti-Cp titre: Cp-ve, n=4 (7%);
Cp-I, n=11 (15%); Cp+ve-NR, n=6 (30%); and Cp+ve-P, n=5 (25%).
Cp+ve-NR and Cp+ve-P groups had a fourfold-increased risk for adverse
cardiovascular events compared with the Cp-ve group
(odds ratio [OR], 4.2; 95% confidence interval [CI], 1.2 to 15.5;
P=.03). In contrast, the OR for
cardiovascular events in patients receiving
azithromycin (Cp+ve-A, single or double course) was the same as in the
Cp-ve group (OR, 0.9; 95% CI, 0.2 to 4.6, P=NS). Patients
receiving azithromycin were more likely to experience a decrease in IgG
anti-Cp titres than were those in the placebo group
(P=.02).
Conclusions An increased anti-Cp antibody titre may be a predictor for further adverse cardiovascular events in post-MI patients. Taking a short course of azithromycin may lower this risk, possibly by acting against Cp.
Key Words: Chlamydia pneumoniae • antibodies • myocardial infarction • azithromycin
|
Introduction |
|---|
|
TopAbstractIntroductionMethodsResultsDiscussionReferences |
|---|
Chronic infections may initiate and perpetuate vascular endothelial damage.1 Cp, an obligate intracellular pathogen, has been recently implicated in atherogenesis. Epidemiological studies demonstrate a consistent association between elevated Cp antibody titres and MI or chronic CHD,2 3 4 but prospective data are sparse.5 Whether an elevated antibody titre reflects new, reactivated, or past infection is unclear because laboratory culture of the organism is difficult. Cp elementary bodies and DNA have been demonstrated within atheromatous coronary arteries,6 7 but the organism could reside within plaque lesions as an "innocent bystander." Azithromycin is a new-generation macrolide (azalide) antibiotic that is well tolerated by patients,8 achieves high tissue concentrations, and has a long half-life.9 A short course of the drug is very effective in treating respiratory infection caused by Cp,10 and a single dose may be sufficient to cure other chlamydial infections.11
We investigated whether anti-Cp titre is a marker for further adverse cardiovascular events in male survivors of MI and examined the effects of azithromycin therapy in the subgroup of patients with stable elevated anti-Cp titres.
|
Methods |
|---|
|
TopAbstractIntroductionMethodsResultsDiscussionReferences |
|---|
Study Design
Between February 1995 and September 1995, 220 consecutive male patients attending a post-MI outpatient clinic at St George's Hospital were enrolled. Patients were screened for serum IgG antibodies against Cp by a microimmunofluorescence assay with elementary bodies of Cp strain IOL-207 as test antigen. We excluded patients with chronic bronchitis, those currently taking macrolide antibiotics, and those with MI within the preceding 6 months (to ensure resolution of immune responses caused by infarction). Also excluded were any subjects with serum that cross-reacted with Chlamydia trachomatis or Chlamydia psitticai antigens, as previously described.4 Patients were stratified into one of three anti-Cp antibody titre groups: group Cp-ve (n=59), no detectable anti-Cp antibodies (seronegative); group Cp-I (n=74), seropositive at a serum dilution of between 1/8 and 1/32; and group Cp+ve (n=80), seropositive at a serum dilution of
1/64. Anti-Cp
antibody titres were remeasured after 3 months in the latter group.
Patients with Cp titre (1 in 64) on both occasions were entered in a
double-blind placebo-controlled study of the effects of azithromycin
therapy (either 500 mg/d for 3 days or two such courses 3 months
apart) on anti-Cp titre and hemostatic and inflammatory markers in
post-MI patients.12 These patients had their anti-Cp titre
and other markers tested at 3 and at 6 months. Adverse cardiovascular events (defined as the first admission to hospital with nonfatal MI; unstable angina requiring either intravenous anti-anginal therapy, coronary angioplasty, or urgent coronary artery bypass surgery; or cardiovascular death) were monitored for 18 months from the original Cp titre determination. The information was obtained from patients' clinic visits, telephone inquiries, case notes, and hospital computerized records.
The study was approved by the local Ethics Committee. All patients gave informed consent.
Statistical Analysis
The frequency of adverse events was assessed in groups Cp-ve,
Cp-I, and Cp+ve. Additionally, Cp+ve patients were further divided into
three subgroups: Cp+ve-NR, patients who did not enter the antibiotic
study; Cp+ve-P, patients who were randomized to receive placebo
medication; and Cp+ve-A, patients who were given either a single or
double course of azithromycin.
The proportion of patients experiencing an adverse event was compared
between group Cp-ve and all other groups by use of the
2 test. The ORs for adverse
cardiovascular events in each Cp+ve group relative to
group Cp-ve were calculated by use of a multiple logistic regression
model before and after adjustment for age, diabetes mellitus,
hypertension, hyperlipidemia, smoking status (current,
ever, or never), and previous coronary artery bypass surgery or
percutaneous transluminal coronary angioplasty
(STATA analysis). A value of P<.05 was considered
significant.
|
Results |
|---|
|
TopAbstractIntroductionMethodsResultsDiscussionReferences |
|---|
Seven patients were excluded because their sera cross-reacted with other chlamydial species; analysis is hence based on the remaining 213 patients. Table 1
shows the
baseline clinical characteristics. Anti-Cp titre was persistently
elevated (1/64) in 72 of 80 Cp+ve patients (90%). Of these 72
patients, 60 were recruited into the antibiotic trial. Of these 60
patients, 20 received placebo, 28 received a single course of
azithromycin, and 12 received two courses of azithromycin. Of the
remaining 12 patients, 7 were unwilling to enter the trial, and 5 had
other serious medical conditions that prevented their inclusion.
|
At 6 months, in the patients participating in the antibiotic trial,
anti-Cp titre fell to 
1/16 in 43% of patients (17 of 40) receiving
azithromycin compared with only 10% patients (2 of 20) taking placebo
(P=.02). The ORs for adverse cardiovascular
events are shown for all groups in Table 2. The frequency of adverse events
increased with rising anti-Cp titre, which persisted after correction
for confounding variables. Because there were no significant
differences in cardiovascular risk factors or events
between the Cp+ve-NR and Cp+ve-P groups, results of the two groups were
combined in the calculation of the ORs. The rate of further
cardiovascular events in the Cp+ve-A group was similar
to that in the Cp-ve group (8% versus 7%; OR, 0.9; P=NS).
Compared with patients in the combined placebo/nonrandomized group, the
azithromycin-treated group had a fivefold reduction in
cardiovascular events, with an OR of 0.2 (95%
confidence interval, 0.05 to 0.8; P=.03). There was no
difference between the patients receiving either single or double
azithromycin course in the proportion having a decrease in anti-Cp
titre or the cardiovascular event rate.
|
|
Discussion |
|---|
|
TopAbstractIntroductionMethodsResultsDiscussionReferences |
|---|
This study is the first to assess the relationship between anti-Cp titre and clinical outcome prospectively in a consecutive group of male survivors of MI and to observe a reduction in cardiovascular event rate after antibiotic treatment. The subjects in this study had had an MI as long as 120 months before and are unrepresentative of all MI patients. However, the mean time elapsed since MI was similar in those having further adverse cardiovascular events compared with those who did not (42±29 versus 45±30 months, respectively). Furthermore, adding time since MI into the logistic regression model showed that compared with the Cp-ve group, there was still a fourfold-increased risk for further cardiovascular events in the Cp+ve-NR and Cp+ve-P groups and a relative OR of 0.9 for events in the azithromycin group.
It is not clear whether elevated anti-Cp antibody titre
represents active or past infection. Ninety percent of post-MI
patients had stable elevated IgG titres when rechecked at 3 months,
consistent with persistent antigenic stimulation resulting from
chronic active infection. In a matched group of male control subjects
without CHD, we found that only 11% had persistently elevated IgG
anti-Cp titres (1/64) when the tests were rechecked 3 months
later.13 Theoretically, increased anti-Cp titre might
result from cross-reactions with other antigens, eg, to other
microorganisms or to heat shock protein 65 (which is implicated in the
atherogenesis14 ). This is unlikely in our study, however,
because titres were specific for Cp and only 7 of 220 subjects (3%)
exhibited antibody cross-reactivity with C.
trachomatis and C. psitticai.
Furthermore, elevated antibody titres fell after treatment with
azithromycin, which has high activity against Cp. The association
between further cardiovascular events and anti-Cp titre
may result from confounding by conventional risk factors. Contrary to
this possibility, however, is the fact that anti-Cp titre remained an
independent risk factor for future cardiovascular
events after controlling for confounding clinical variables, such
as smoking and diabetes mellitus. The vast majority of patients
(>95%) in each of the Cp titre groups were taking regular aspirin, so
this could not account for the improved clinical outcome in the
azithromycin-treated group. Furthermore, all 29 patients with
recorded cardiovascular events were on regular
aspirin.
Possible explanations for the association between elevated anti-Cp antibody titres and risk of adverse cardiovascular events include direct involvement of Cp in atherogenesis. Chronic infection of macrophages may contribute to inflammatory processes15 16 or trigger a procoagulant state through tissue factor expression.12 17 The bacterial lipopolysaccharide cell wall itself may contribute to direct endothelial cell damage. Kuo et al6 showed that the chances of identifying Cp within atherosclerotic lesions was inversely related to serum antibody, suggesting that hypersensitivity to Cp may play a role in atherogenesis, analogous to the involvement of C. trachomatis in the pathogenesis of trachoma.18 However, the study findings by Kuo et al were based on a small number of autopsy coronary atheroma specimens, and the antibody titres from hemolysed sera were difficult to evaluate. Furthermore, when similar diagnostic techniques were used in a more recent study, results demonstrated Cp organisms within coronary atherectomy specimens of patients with angina and found no such inverse relationship between the likelihood of detecting the organism and the height of the Cp-specific antibody titre.19 It is hence reasonable to propose that azithromycin may have been acting against Cp within the coronary arteries of our post-MI patients with elevated antibody titres. This may account for the observed reduction in adverse cardiovascular events in the treated group.
Whatever the relationship between anti-Cp titre and cardiovascular outcome, the reduction in event rate after treatment with azithromycin is intriguing, particularly because the benefit was not restricted to subjects who had a decrease in titres. Azithromycin, by eradicating or suppressing infection, may have helped to "stabilize" active plaque lesions, in part by dampening inflammation and hypercoagulation.12 Azithromycin may have acted against other infections, eg, Helicobacter pylori, which has been linked to prevalent CHD and cardiovascular risk factors.15 Alternatively, the results seen could be secondary to an effect unrelated to the antimicrobial action of azithromycin. The inclusion of an arm in our antibiotic trial in which Cp-ve subjects (presumed free of infection) were treated may have helped to clarify whether the effect of the antibody resulted from direct action against Cp or through other mechanisms. We cannot dismiss the possibility that additional antibiotic treatment for intercurrent infections was taken by patients, but such usage would probably be low and similar for all subgroups. Finally, given that anti-Cp antibody titres are also associated with atherosclerotic disease other than CHD,20 future studies are needed to ascertain whether the graded risks with anti-Cp antibody titre apply to those CHD patients yet to suffer from MI or to other high-risk groups (such as those with atheromatous peripheral vascular or cerebrovascular disease).
In conclusion, these findings may have important implications for the secondary prevention of CHD, especially given the safety of azithromycin and the fact that the beneficial effects are observed after only a short course of treatment. Larger antibiotic eradication trials, now being designed, are needed to confirm these findings.
|
Selected Abbreviations and Acronyms |
|---|
|
|
Acknowledgments |
|---|
The study was funded by the British Heart Foundation; Dr Sandeep Gupta is supported by a British Heart Foundation Junior Research Fellowship (FS/94075). We thank Pfizer Ltd (Sandwich, Kent, UK) for supplying the azithromycin and placebo tablets and Dr Ike Iheanacho for making critical comments on the manuscript.
Received March 17, 1997; revision received May 23, 1997; accepted May 28, 1997.
|
References |
|---|
|
TopAbstractIntroductionMethodsResultsDiscussionReferences |
|---|
1. Ross R. The pathogenesis of atherosclerosis: an update. N Engl J Med. 1986;314:488-500.[Medline] [Order article via Infotrieve]
2. Saikku P, Leinonen M, Mattila KJ, Ekman MR, Nieminen MS, Makela PH, Huttunen JK, Valtonen V. Serological evidence of an association of a novel chlamydia, TWAR, with chronic coronary heart disease and acute myocardial infarction. Lancet. 1988;2:983-986.[Medline] [Order article via Infotrieve]
3.
Thom DH, Grayston JT, Siscovick DS, Wang SP, Weiss NS,
Daling JR. Association of prior infection with
Chlamydia pneumoniae and angiographically demonstrated
coronary artery disease. JAMA. 1992;268:68-72.
4. Mendall MA, Carrington D, Strachan DP, Patel P, Molineaux N, Levy J, Toosey T, Camm AJ, Northfield TC. Chlamydia pneumoniae: risk factors for seropositivity and association with coronary heart disease. J Infect. 1995;30:121-128.[Medline] [Order article via Infotrieve]
5. Saikku P, Leiononen M, Tenkanen L, Linnanmaki E, Ekman MR, Manniven V, Mantarri M, Frick MH, Huttenen JK. Chronic Chlamydia pneumoniae infection as a risk factor for coronary heart disease in the Helsinki Heart Study. Ann Intern Med. 1992;116:273-277.
6. Kuo C-C, Shor A, Campbell LA, Fukushi H, Patton DL, Grayston JT. Demonstration of Chlamydia pneumoniae in atherosclerotic lesions of coronary arteries. J Infect Dis. 1993;167:841-849.[Medline] [Order article via Infotrieve]
7. Muhlestein JB, Hammond EH, Carlquist JF, Radicke E, Thomson MJ, Karagounis LA, Woods ML, Anderson JL. Increased incidence of Chlamydia species within the coronary arteries of patients with symptomatic atherosclerotic versus other forms of cardiovascular disease. J Am Coll Cardiol. 1996;27:1555-1561.[Abstract]
8. Hopkins S. Clinical toleration and safety of azithromycin. Am J Med. 1991;91(suppl 3A);342:453-456.
9. Foulds G, Shepard RM, Johnson RB. The pharmacokinetics of azithromycin in human serum and tissues. J Antimicrob Chemother. 1990;25(suppl A):73-82.
10. Rizzato G, Montemurro L, Fraioli P, Montanari G, Fanti D, Pozzoli R, Magliano E. Efficacy of a three day course of azithromycin in moderately severe community-acquired pneumonia. Eur Respir J. 1995;8:398-402.[Abstract]
11. Bailey RL, Arullendran P, Whittle HC, Mabey DCW. Randomised controlled trial of single-dose azithromycin in treatment of trachoma. Lancet. 1993;342:453-456.[Medline] [Order article via Infotrieve]
12. Gupta S, Leatham EW, Carrington D, Mendall MA, Ireson N, Tooze J, Bevan D, Kaski JC, Camm AJ. The effect of azithromycin in post-myocardial infarction patients with elevated Chlamydia pneumoniae antibody titres. J Am Coll Cardiol. 1997;755-2. Abstract.
13. Gupta S, Carrington D, Leatham EW, Ireson N, Wong H, Mendall MA, Patel P, Camm AJ, Kaski JC. Chronic Chlamydia pneumoniae infection in post-myocardial infarction patients. Eur Heart J. 1996;2367. Abstract.
14. Xu Q, Willeit J, Marosi M, Kleindienst R, Oberhollenzer F, Kiechl S, Stulnig T, Luef G, Wick G. Association of serum antibodies to heat shock protein 65 with carotid atherosclerosis. Lancet. 1993;341:255-259.[Medline] [Order article via Infotrieve]
15.
Patel P, Mendall MA, Carrington D, Strachan DP, Leatham
EW, Molineaux N, Levy J, Blakeston C, Seymour CA, Camm AJ, Northfield
TC. Association of Helicobacter pylori and
Chlamydia pneumoniae infections with coronary heart
disease and cardiovascular risk factors.
BMJ. 1995;311:711-714.
16. Patel P, Carrington D, Strachan DP, Leatham EW, Goggin P, Northfield TC, Mendall MA. Fibrinogen: a link between chronic infection and coronary heart disease. Lancet. 1994;343:1634-1635.[Medline] [Order article via Infotrieve]
17.
Leatham EW, Bath PM, Tooze JA, Camm AJ.
Increased monocyte tissue factor expression in coronary
disease. Br Heart J. 1995;73:10-13.
18. Holland MJ, Bailey RL, Ward ME, Morrison R, Whittle HC, Mabey DC. Cell mediated immune responses to Chlamydia trachomatis in scarring trachoma. Proc Eur Soc Chlam Res. 1992;2:134.
19. Campbell LA, O'Brien ER, Cappuccio AL, Kuo C-C, Wang S-P, Stewart D, Patton DL, Cummings PK, Grayston JT. Detection of Chlamydia pneumoniae TWAR in human coronary atherectomy tissues. J Infect Dis. 1995;172:585-588.[Medline] [Order article via Infotrieve]
20. Melnick SL, Shahar E, Folson AR, Grayston JT, Sorlie PD, Wang S-P, Szklo M. Past infection by Chlamydia pneumoniae strain TWAR and asymptomatic carotid atherosclerosis. Am J Med. 1993;95:499-504.[Medline] [Order article via Infotrieve]
This article has been cited by other articles:
 |
|
 |
|
  S. Amar, S.-c. Wu, and M. Madan Is Porphyromonas gingivalis Cell Invasion Required for Atherogenesis? Pharmacotherapeutic Implications J. Immunol., February 1, 2009; 182(3): 1584 - 1592. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 I. Volanen, K. Kallio, M. Saarinen, M. J. Jarvisalo, R. Vainionpaa, T. Ronnemaa, J. Viikari, J. Marniemi, O. Simell, and O. T. Raitakari Arterial Intima-Media Thickness in 13-Year-Old Adolescents and Previous Antichlamydial Antimicrobial Use: A Retrospective Follow-up Study Pediatrics, September 1, 2008; 122(3): e675 - e681. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 W. L. Baker and K. A. Couch Azithromycin for the secondary prevention of coronary artery disease: A meta-analysis Am. J. Health Syst. Pharm., April 15, 2007; 64(8): 830 - 836. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 L. B. Goldstein, R. Adams, M. J. Alberts, L. J. Appel, L. M. Brass, C. D. Bushnell, A. Culebras, T. J. DeGraba, P. B. Gorelick, J. R. Guyton, et al. Primary Prevention of Ischemic Stroke: A Guideline From the American Heart Association/American Stroke Association Stroke Council: Cosponsored by the Atherosclerotic Peripheral Vascular Disease Interdisciplinary Working Group; Cardiovascular Nursing Council; Clinical Cardiology Council; Nutrition, Physical Activity, and Metabolism Council; and the Quality of Care and Outcomes Research Interdisciplinary Working Group: The American Academy of Neurology affirms the value of this guideline. Circulation, June 20, 2006; 113(24): e873 - e923. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 L. B. Goldstein, R. Adams, M. J. Alberts, L. J. Appel, L. M. Brass, C. D. Bushnell, A. Culebras, T. J. DeGraba, P. B. Gorelick, J. R. Guyton, et al. Primary Prevention of Ischemic Stroke: A Guideline From the American Heart Association/American Stroke Association Stroke Council: Cosponsored by the Atherosclerotic Peripheral Vascular Disease Interdisciplinary Working Group; Cardiovascular Nursing Council; Clinical Cardiology Council; Nutrition, Physical Activity, and Metabolism Council; and the Quality of Care and Outcomes Research Interdisciplinary Working Group: The American Academy of Neurology affirms the value of this guideline. Stroke, June 1, 2006; 37(6): 1583 - 1633. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. S.V. Elkind, M. L. C. Tondella, D. R. Feikin, B. S. Fields, S. Homma, and M. R. Di Tullio Seropositivity to Chlamydia pneumoniae Is Associated With Risk of First Ischemic Stroke Stroke, March 1, 2006; 37(3): 790 - 795. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. J. Ott, N. E. El Mokhtari, M. Musfeldt, S. Hellmig, S. Freitag, A. Rehman, T. Kuhbacher, S. Nikolaus, P. Namsolleck, M. Blaut, et al. Detection of Diverse Bacterial Signatures in Atherosclerotic Lesions of Patients With Coronary Heart Disease Circulation, February 21, 2006; 113(7): 929 - 937. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C. M Jespersen, B. Als-Nielsen, M. Damgaard, J. F. Hansen, S. Hansen, O. H Helo, P. Hildebrandt, J. Hilden, G. B Jensen, J. Kastrup, et al. Randomised placebo controlled multicentre trial to assess short term clarithromycin for patients with stable coronary heart disease: CLARICOR trial BMJ, January 7, 2006; 332(7532): 22 - 27. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. Taylor-Robinson and J. Boman The failure of antibiotics to prevent heart attacks BMJ, August 13, 2005; 331(7513): 361 - 362. [Full Text] [PDF]
|
|
|
|
 |
|
 R. Andraws, J. S. Berger, and D. L. Brown Effects of Antibiotic Therapy on Outcomes of Patients With Coronary Artery Disease: A Meta-analysis of Randomized Controlled Trials JAMA, June 1, 2005; 293(21): 2641 - 2647. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. Berman, D. Hasdai, E. Raanani, G. P. Georghiou, L. Kapustin, Y. Chepurko, B. A. Vidne, and E. Hochhauser Ex-vivo effect of roxithromycin on human and rat arterial vasoactivity Interactive CardioVascular and Thoracic Surgery, June 1, 2005; 4(3): 232 - 237. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C. P. Cannon, E. Braunwald, C. H. McCabe, J. T. Grayston, B. Muhlestein, R. P. Giugliano, R. Cairns, A. M. Skene, and the Pravastatin or Atorvastatin Evaluation and Inf Antibiotic Treatment of Chlamydia pneumoniae after Acute Coronary Syndrome N. Engl. J. Med., April 21, 2005; 352(16): 1646 - 1654. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. L. Anderson Infection, Antibiotics, and Atherothrombosis -- End of the Road or New Beginnings? N. Engl. J. Med., April 21, 2005; 352(16): 1706 - 1709. [Full Text] [PDF]
|
|
|
|
 |
|
 S C Bell, S L Senini, and J G McCormack Macrolides in cystic fibrosis Chronic Respiratory Disease, April 1, 2005; 2(2): 85 - 98. [Abstract] [PDF]
|
|
|
|
 |
|
 G Arno, J C Kaski, D A Smith, J P Akiyu, S E Hughes, and C Baboonian Matrix metalloproteinase-9 expression is associated with the presence of Chlamydia pneumoniae in human coronary atherosclerotic plaques Heart, April 1, 2005; 91(4): 521 - 525. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 H. F. Berg, B. Maraha, A. van der Zee, S. K. Gielis, P. J. M. Roholl, G.-J. Scheffer, M. F. Peeters, and J. A. J. W. Kluytmans Effect of Clarithromycin Treatment on Chlamydia pneumoniae in Vascular Tissue of Patients with Coronary Artery Disease: a Randomized, Double-Blind, Placebo-Controlled Trial J. Clin. Microbiol., March 1, 2005; 43(3): 1325 - 1329. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. A Voils, M. E Evans, M. T Lane, R. H Schosser, and R. P Rapp Use of Macrolides and Tetracyclines for Chronic Inflammatory Diseases Ann. Pharmacother., January 1, 2005; 39(1): 86 - 94. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 B. J. Wells, A. G. Mainous III, and L. M. Dickerson Antibiotics for the Secondary Prevention of Ischemic Heart Disease: A Meta-analysis of Randomized Controlled Trials Arch Intern Med, October 25, 2004; 164(19): 2156 - 2161. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 L. Tormakangas, H. Alakarppa, D. B. David, M. Leinonen, and P. Saikku Telithromycin Treatment of Chronic Chlamydia pneumoniae Infection in C57BL/6J mice Antimicrob. Agents Chemother., October 1, 2004; 48(10): 3655 - 3661. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Madjid, M. Naghavi, S. Litovsky, and S. W. Casscells Influenza and Cardiovascular Disease: A New Opportunity for Prevention and the Need for Further Studies Circulation, December 2, 2003; 108(22): 2730 - 2736. [Full Text] [PDF]
|
|
|
|
 |
|
 T. T Keller, A. T.A Mairuhu, M. D de Kruif, S. K Klein, V. E.A Gerdes, H. ten Cate, D. P.M Brandjes, M. Levi, and E. C.M van Gorp Infections and endothelial cells Cardiovasc Res, October 15, 2003; 60(1): 40 - 48. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. J. Lindsberg and A. J. Grau Inflammation and Infections as Risk Factors for Ischemic Stroke Stroke, October 1, 2003; 34(10): 2518 - 2532. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. M. O'Connor, M. W. Dunne, M. A. Pfeffer, J. B. Muhlestein, L. Yao, S. Gupta, R. J. Benner, M. R. Fisher, and T. D. Cook Azithromycin for the Secondary Prevention of Coronary Heart Disease Events: The WIZARD Study: A Randomized Controlled Trial JAMA, September 17, 2003; 290(11): 1459 - 1466. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. V. Pislaru and F. Van de Werf Antibiotic Therapy for Coronary Artery Disease: Can a WIZARD Change It All? JAMA, September 17, 2003; 290(11): 1515 - 1516. [Full Text] [PDF]
|
|
|
|
 |
|
 C. H. Selzman, M. G. Netea, M. A. Zimmerman, A. Weinberg, L. L. Reznikov, F. L. Grover, and C. A. Dinarello Atherogenic effects of Chlamydia pneumoniae: refuting the innocent bystander hypothesis J. Thorac. Cardiovasc. Surg., September 1, 2003; 126(3): 688 - 693. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D Tousoulis, G Davies, C Stefanadis, P Toutouzas, and J A Ambrose Inflammatory and thrombotic mechanisms in coronary atherosclerosis Heart, September 1, 2003; 89(9): 993 - 997. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 H. F. Berg, B. Maraha, G.-J. Scheffer, M. F. Peeters, and J. A. J. W. Kluytmans Effect of Clarithromycin on Inflammatory Markers in Patients with Atherosclerosis Clin. Vaccine Immunol., July 1, 2003; 10(4): 525 - 528. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. J. Karter, D. H. Thom, J. Liu, H. H. Moffet, A. Ferrara, and J. V. Selby Use of Antibiotics Is Not Associated With Decreased Risk of Myocardial Infarction Among Patients With Diabetes Diabetes Care, July 1, 2003; 26(7): 2100 - 2106. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 T-M Lin, W-j Chen, H-Y Chen, P-W Wang, and H-L Eng Increased incidence of cytomegalovirus but not Chlamydia pneumoniae in atherosclerotic lesions of arteries of lower extremities from patients with diabetes mellitus undergoing amputation J. Clin. Pathol., June 1, 2003; 56(6): 429 - 432. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. T. Grayston Antibiotic Treatment of Atherosclerotic Cardiovascular Disease Circulation, March 11, 2003; 107(9): 1228 - 1230. [Full Text] [PDF]
|
|
|
|
|
|
R. Zahn, S. Schneider, B. Frilling, K. Seidl, U. Tebbe, M. Weber, M. Gottwik, E. Altmann, F. Seidel, J. Rox, et al. Antibiotic Therapy After Acute Myocardial Infarction: A Prospective Randomized Study Circulation, March 11, 2003; 107(9): 1253 - 1259. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. P. Higgins Chlamydia pneumoniae and Coronary Artery Disease: The Antibiotic Trials Mayo Clin. Proc., March 1, 2003; 78(3): 321 - 332. [Abstract] [PDF]
|
|
|
|
 |
|
 D. J. Angiolillo, G. Liuzzo, S. Pelliccioni, E. De Candia, R. Landolfi, F. Crea, A. Maseri, and L. M. Biasucci Combined role of the Lewis antigenic system, Chlamydia pneumoniae, and C-reactive protein in unstable angina J. Am. Coll. Cardiol., February 19, 2003; 41(4): 546 - 550. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. D. Spence and J. Norris Infection, Inflammation, and Atherosclerosis Stroke, February 1, 2003; 34(2): 333 - 334. [Full Text] [PDF]
|
|
|
|
|
|
A. Paganini-Hill, E. Lozano, G. Fischberg, M. Perez Barreto, K. Rajamani, S.F. Ameriso, P.N.R. Heseltine, and M. Fisher Infection and Risk of Ischemic Stroke: Differences Among Stroke Subtypes Stroke, February 1, 2003; 34(2): 452 - 457. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. V. Kalayoglu, P. Libby, and G. I. Byrne Chlamydia pneumoniae as an Emerging Risk Factor in Cardiovascular Disease JAMA, December 4, 2002; 288(21): 2724 - 2731. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. S. Forrester Prevention of Plaque Rupture: A New Paradigm of Therapy Ann Intern Med, November 19, 2002; 137(10): 823 - 833. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
F.-J. Neumann Chlamydia pneumoniae-Atherosclerosis Link: A Sound Concept in Search for Clinical Relevance Circulation, November 5, 2002; 106(19): 2414 - 2416. [Full Text] [PDF]
|
|
|
|
|
|
D. Sander, K. Winbeck, J. Klingelhofer, T. Etgen, and B. Conrad Reduced Progression of Early Carotid Atherosclerosis After Antibiotic Treatment and Chlamydia pneumoniae Seropositivity Circulation, November 5, 2002; 106(19): 2428 - 2433. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. S.V. Elkind, R. Sciacca, B. Boden-Albala, S. Homma, and M. R. Di Tullio Leukocyte Count Is Associated With Aortic Arch Plaque Thickness Stroke, November 1, 2002; 33(11): 2587 - 2592. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R Ezzahiri, H.J.M.G Nelissen-Vrancken, H.A.J.M Kurvers, F.R.M Stassen, I Vliegen, G.E.L.M Grauls, M.M.L van Pul, P.J.E.H.M Kitslaar, and C.A Bruggeman Chlamydophila pneumoniae (Chlamydia pneumoniae) accelerates the formation of complex atherosclerotic lesions in Apo E3-Leiden mice Cardiovasc Res, November 1, 2002; 56(2): 269 - 276. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. W. Haider, P. W. F. Wilson, M. G. Larson, J. C. Evans, E. L. Michelson, P. A. Wolf, C. J. O'Donnell, and D. Levy The association of seropositivity to Helicobacter pylori, Chlamydia pneumoniae, and cytomegalovirus with risk of cardiovascular disease: A prospective study J. Am. Coll. Cardiol., October 16, 2002; 40(8): 1408 - 1413. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. R. Hammerschlag, J.C. Kaski, N. Parchure, and E. Zouridakis Effect of Azithromycin on Endothelial Function of Patients With Coronary Artery Disease and Evidence of Chlamydia pneumoniae Infection * Response Circulation, October 8, 2002; 106 (15): e65 - e66. [Full Text] [PDF]
|
|
|
|
 |
|
 F. Delahaye, E. P. McFadden, and G. de Gevigney The scourge of coronary disease in diabetic patients: will antibiotics sweeten the pill? Eur. Heart J., October 2, 2002; 23(20): 1557 - 1559. [Full Text] [PDF]
|
|
|
|
|
|
J.A. Erkens, O.H. Klungel, R.M.C. Herings, R.P. Stolk, J.A. Spoelstra, D.E. Grobbee, and H.G.M. Leufkens Use of fluorquinolones is associated with a reduced risk of coronary heart disease in diabetes mellitus type 2 patients Eur. Heart J., October 2, 2002; 23(20): 1575 - 1579. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. F.M. Stone, M. A. Mendall, J.-C. Kaski, T. M. Edger, P. Risley, J. Poloniecki, A. J. Camm, and T. C. Northfield Effect of Treatment for Chlamydia pneumoniae and Helicobacter pylori on Markers of Inflammation and Cardiac Events in Patients With Acute Coronary Syndromes: South Thames Trial of Antibiotics in Myocardial Infarction and Unstable Angina (STAMINA) Circulation, September 3, 2002; 106(10): 1219 - 1223. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
I. W. Fong, B. Chiu, E. Viira, D. Jang, and J. B. Mahony Influence of Clarithromycin on Early Atherosclerotic Lesions after Chlamydia pneumoniae Infection in a Rabbit Model Antimicrob. Agents Chemother., August 1, 2002; 46(8): 2321 - 2326. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. Saren, S. Pascolo, S. Stevanovic, T. Dumrese, M. Puolakkainen, M. Sarvas, H.-G. Rammensee, and J. M. Vuola Identification of Chlamydia pneumoniae-Derived Mouse CD8 Epitopes Infect. Immun., July 1, 2002; 70(7): 3336 - 3343. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. W. Kerrigan, I. Douglas, A. Wray, J. Heath, M. F. Byrne, D. Fitzgerald, and D. Cox A role for glycoprotein Ib in Streptococcus sanguis-induced platelet aggregation Blood, June 28, 2002; 100(2): 509 - 516. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. Wiesli, W. Czerwenka, A. Meniconi, F. E. Maly, U. Hoffmann, W. Vetter, and G. Schulthess Roxithromycin Treatment Prevents Progression of Peripheral Arterial Occlusive Disease in Chlamydia pneumoniae Seropositive Men: A Randomized, Double-Blind, Placebo-Controlled Trial Circulation, June 4, 2002; 105(22): 2646 - 2652. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J.L. Alonso-Martinez, B. Llorente-Diez, M. Echegaray-Agara, F. Olaz-Preciado, M. Urbieta-Echezarreta, and C. Gonzalez-Arencibia C-reactive protein as a predictor of improvement and readmission in heart failure Eur J Heart Fail, June 1, 2002; 4(3): 331 - 336. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
N. Parchure, E. G. Zouridakis, and J. C. Kaski Effect of Azithromycin Treatment on Endothelial Function in Patients With Coronary Artery Disease and Evidence of Chlamydia pneumoniae Infection Circulation, March 19, 2002; 105(11): 1298 - 1303. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. Lehto, L. Niskanen, M. Suhonen, T. Ronnemaa, P. Saikku, and M. Laakso Association Between Chlamydia pneumoniae Antibodies and Intimal Calcification in Femoral Arteries of Nondiabetic Patients Arch Intern Med, March 11, 2002; 162(5): 594 - 599. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. Stollberger and J. Finsterer Role of Infectious and Immune Factors in Coronary and Cerebrovascular Arteriosclerosis Clin. Vaccine Immunol., March 1, 2002; 9(2): 207 - 215. [Full Text] [PDF]
|
|
|
|
|
|
P. B. Gorelick Stroke Prevention Therapy Beyond Antithrombotics: Unifying Mechanisms in Ischemic Stroke Pathogenesis and Implications for Therapy: An Invited Review Stroke, March 1, 2002; 33(3): 862 - 875. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. Tavendale, D. Parratt, S.D. Pringle, R. A'brook, and H. Tunstall-Pedoe Serological markers of Chlamydia pneumoniae infection in men and women and subsequent coronary events. The Scottish Heart Health Study Cohort Eur. Heart J., February 2, 2002; 23(4): 301 - 307. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Kutlin, P. M. Roblin, and M. R. Hammerschlag Effect of Prolonged Treatment with Azithromycin, Clarithromycin, or Levofloxacin on Chlamydia pneumoniae in a Continuous-Infection Model Antimicrob. Agents Chemother., February 1, 2002; 46(2): 409 - 412. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. Takeshita, Y. Ono, K. Kozuma, M. Suzuki, Y. Kawamura, N. Yokoyama, T. Furukawa, and T. Isshiki Modulation of oxidative burst of neutrophils by doxycycline in patients with acute myocardial infarction J. Antimicrob. Chemother., February 1, 2002; 49(2): 411 - 413. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. L. C. Tondella, D. F. Talkington, B. P. Holloway, S. F. Dowell, K. Cowley, M. Soriano-Gabarro, M. S. Elkind, and B. S. Fields Development and Evaluation of Real-Time PCR-Based Fluorescence Assays for Detection of Chlamydiapneumoniae J. Clin. Microbiol., February 1, 2002; 40(2): 575 - 583. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. Lavallee, V. Perchaud, M. Gautier-Bertrand, D. Grabli, and P. Amarenco Association Between Influenza Vaccination and Reduced Risk of Brain Infarction Stroke, February 1, 2002; 33(2): 513 - 518. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. Boman and M. R. Hammerschlag Chlamydia pneumoniae and Atherosclerosis: Critical Assessment of Diagnostic Methods and Relevance to Treatment Studies Clin. Microbiol. Rev., January 1, 2002; 15(1): 1 - 20. [Abstract] [Full Text]
|
|
|
|
|
|
S. Montigiani, F. Falugi, M. Scarselli, O. Finco, R. Petracca, G. Galli, M. Mariani, R. Manetti, M. Agnusdei, R. Cevenini, et al. Genomic Approach for Analysis of Surface Proteins in Chlamydia pneumoniae Infect. Immun., January 1, 2002; 70(1): 368 - 379. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. Farzaneh-Far, J. Rudd, and P. L Weissberg Inflammatory mechanisms: Ischaemic heart disease Br. Med. Bull., October 1, 2001; 59(1): 55 - 68. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. Monaco, F. Crea, G. Niccoli, F. Summaria, D. Cianflone, R. Bordone, G. Bellomo, and A. Maseri Autoantibodies against oxidized low density lipoproteins in patients with stable angina, unstable angina or peripheral vascular disease; pathophysiological implications Eur. Heart J., September 1, 2001; 22(17): 1572 - 1577. [Abstract] [PDF]
|
|
|
|
 |
|
 C. H. Selzman, S. A. Miller, and A. H. Harken Therapeutic implications of inflammation in atherosclerotic cardiovascular disease Ann. Thorac. Surg., June 1, 2001; 71(6): 2066 - 2074. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. S. Elkind, J. Cheng, B. Boden-Albala, M. C. Paik, and R. L. Sacco Elevated White Blood Cell Count and Carotid Plaque Thickness : The Northern Manhattan Stroke Study Stroke, April 1, 2001; 32(4): 842 - 849. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. VALASSINA, L. MIGLIORINI, A. SANSONI, G. SANI, D. CORSARO, M. G. CUSI, P. E. VALENSIN, and C. CELLESI Search for Chlamydia pneumoniae genes and their expression in atherosclerotic plaques of carotid arteries J. Med. Microbiol., March 1, 2001; 50(3): 228 - 232. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. K. Shah Link Between Infection and Atherosclerosis: Who Are The Culprits: Viruses, Bacteria, Both, or Neither? Circulation, January 2, 2001; 103(1): 5 - 6. [Full Text] [PDF]
|
|
|
|
|
|
J. Oetjen, P. Fives-Taylor, and E. Froeliger Characterization of a Streptococcal Endopeptidase with Homology to Human Endothelin-Converting Enzyme Infect. Immun., January 1, 2001; 69(1): 58 - 64. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 P. Vehmaan-Kreula, M. Puolakkainen, M. Sarvas, H. G. Welgus, and P. T. Kovanen Chlamydia pneumoniae Proteins Induce Secretion of the 92-kDa Gelatinase by Human Monocyte- Derived Macrophages Arterioscler Thromb Vasc Biol, January 1, 2001; 21 (1): e1 - e8. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R.R Azar, S Rinfret, P Theroux, P.H Stone, R Dakshinamurthy, Y.-J Feng, A.H.B Wu, G Range, and D.D Waters A randomized placebo-controlled trial to assess the efficacy of antiinflammatory therapy with methylprednisolone in unstable angina (MUNA trial) Eur. Heart J., December 2, 2000; 21(24): 2026 - 2032. [Abstract] [PDF]
|
|
|
|
|
|
G. Y. H. Lip and A. D. Blann Thrombogenesis and fibrinolysis in acute coronary syndromes: Important facets of a prothrombotic or hypercoagulable state? J. Am. Coll. Cardiol., December 1, 2000; 36(7): 2044 - 2046. [Full Text] [PDF]
|
|
|
|
|
|
O. J. de Boer, A. C. van der Wal, M. A. Houtkamp, J. M. Ossewaarde, P. Teeling, and A. E. Becker Unstable atherosclerotic plaques contain T-cells that respond to Chlamydia pneumoniae Cardiovasc Res, December 1, 2000; 48(3): 402 - 408. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. Kaul, J. Uphoff, J. Wiedeman, S. Yadlapalli, and W. M. Wenman Detection of Chlamydia pneumoniae DNA in CD3+ Lymphocytes From Healthy Blood Donors and Patients With Coronary Artery Disease Circulation, November 7, 2000; 102(19): 2341 - 2346. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. T. Grayston Secondary Prevention Antibiotic Treatment Trials for Coronary Artery Disease Circulation, October 10, 2000; 102(15): 1742 - 1743. [Full Text] [PDF]
|
|
|
|
|
|
J. B. Muhlestein, J. L. Anderson, J. F. Carlquist, K. Salunkhe, B. D. Horne, R. R. Pearson, T. J. Bunch, A. Allen, S. Trehan, and C. Nielson Randomized Secondary Prevention Trial of Azithromycin in Patients With Coronary Artery Disease : Primary Clinical Results of the ACADEMIC Study Circulation, October 10, 2000; 102(15): 1755 - 1760. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M.-T. Labro Interference of Antibacterial Agents with Phagocyte Functions: Immunomodulation or ""Immuno-Fairy Tales""? Clin. Microbiol. Rev., October 1, 2000; 13(4): 615 - 650. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 F. Chierichetti, E. Arbustini, V. Arici, S. P. Moghadam, B. Conti, and A. Bagliani Identification of Chlamydia pneumoniae DNA in Carotid Plaques Angiology, October 1, 2000; 51(10): 827 - 830. [Abstract] [PDF]
|
|
|
|
|
|
G. Caligiuri, G. Paulsson, A. Nicoletti, A. Maseri, and G. K. Hansson Evidence for Antigen-Driven T-Cell Response in Unstable Angina Circulation, September 5, 2000; 102(10): 1114 - 1119. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S A Morre, W Stooker, W K Lagrand, A J C van den Brule, and H W M Niessen Microorganisms in the aetiology of atherosclerosis J. Clin. Pathol., September 1, 2000; 53(9): 647 - 654. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K. K. Koh Effects of statins on vascular wall: vasomotor function, inflammation, and plaque stability Cardiovasc Res, September 1, 2000; 47(4): 648 - 657. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Mayr, S. Kiechl, J. Willeit, G. Wick, and Q. Xu Infections, Immunity, and Atherosclerosis : Associations of Antibodies to Chlamydia pneumoniae, Helicobacter pylori, and Cytomegalovirus With Immune Reactions to Heat-Shock Protein 60 and Carotid or Femoral Atherosclerosis Circulation, August 22, 2000; 102(8): 833 - 839. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. Fischer, D. E Gutstein, Z. A Fayad, and V. Fuster Predicting plaque rupture: enhancing diagnosis and clinical decision-making in coronary artery disease Vascular Medicine, August 1, 2000; 5(3): 163 - 172. [Abstract] [PDF]
|
|
|
|
|
|
J. Danesh, P. Whincup, M. Walker, L. Lennon, A. Thomson, P. Appleby, Y.-k. Wong, M. Bernardes-Silva, M. Ward, and R. West Chlamydia pneumoniae IgG titres and coronary heart disease: prospective study and meta-analysis Commentary: Adjustment for potential confounders may have been taken too far BMJ, July 22, 2000; 321(7255): 208 - 213. [Abstract] [Full Text]
|
|
|
|
 |
|
 I. W. Fong Emerging relations between infectious diseases and coronary artery disease and atherosclerosis Can. Med. Assoc. J., July 1, 2000; 163(1): 49 - 56. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A.J. Camm and K.M. Fox Chlamydia pneumonia (and other infective agents) in atherosclerosis and acute coronary syndromes. How good is the evidence? Eur. Heart J., July 1, 2000; 21(13): 1046 - 1051. [PDF]
|
|
|
|
|
|
M. S. V. Elkind, I-F. Lin, J. T. Grayston, and R. L. Sacco Chlamydia pneumoniae and the Risk of First Ischemic Stroke : The Northern Manhattan Stroke Study Stroke, July 1, 2000; 31(7): 1521 - 1525. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
G. Liuzzo, J. J. Goronzy, H. Yang, S. L. Kopecky, D. R. Holmes, R. L. Frye, and C. M. Weyand Monoclonal T-Cell Proliferation and Plaque Instability in Acute Coronary Syndromes Circulation, June 27, 2000; 101(25): 2883 - 2888. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K. Ericson, T. G. P. Saldeen, O. Lindquist, C. Pahlson, and J. L. Mehta Relationship of Chlamydia pneumoniae Infection to Severity of Human Coronary Atherosclerosis Circulation, June 6, 2000; 101(22): 2568 - 2571. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
X. X. Bin, K. Wolf, T. Schaffner, and R. Malinverni Effect of Azithromycin plus Rifampin versus Amoxicillin Alone on Eradication and Inflammation in the Chronic Course of Chlamydia pneumoniae Pneumonitis in Mice Antimicrob. Agents Chemother., June 1, 2000; 44(6): 1761 - 1764. [Abstract] [Full Text]
|
|
|
|
 |
|
 D.S. GRIMES, E. HINDLE, and T. DYER Respiratory infection and coronary heart disease: progression of a paradigm QJM, June 1, 2000; 93(6): 375 - 383. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. E. Rottenberg, A. Gigliotti Rothfuchs, D. Gigliotti, M. Ceausu, C. Une, V. Levitsky, and H. Wigzell Regulation and Role of IFN-{gamma} in the Innate Resistance to Infection with Chlamydia pneumoniae J. Immunol., May 1, 2000; 164(9): 4812 - 4818. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
E. Gurfinkel, G. Bozovich, B. Mautner, J. L. Anderson, J. B. Muhlestein, J. Carlquist, A. Allen, S. Trehan, C. Nielson, S. Hall, et al. Chlamydia pneumoniae in Coronary Artery Disease • Response Circulation, March 28, 2000; 101 (12): e118 - e119. [Full Text] [PDF]
|
|
|
|
|
|
E. Gurfinkel, G. Bozovich, and B. Mautner Chlamydia pneumoniae in Coronary Artery Disease Circulation, March 14, 2000; 101 (10): e95 - e95. [Full Text] [PDF]
|
|
|
|
 |
|
 K.J. Mattila, S. Asikainen, J. Wolf, H. Jousimies-Somer, V. Valtonen, and M. Nieminen Age, Dental Infections, and Coronary Heart Disease Journal of Dental Research, February 1, 2000; 79(2): 756 - 760. [Abstract] [PDF]
|
|
|
|
 |
|
 P. Ammann, S. Marschall, M. Kraus, L. Schmid, W. Angehrn, R. Krapf, and H. Rickli Characteristics and Prognosis of Myocardial Infarction in Patients With Normal Coronary Arteries Chest, February 1, 2000; 117(2): 333 - 338. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. Bartels, M. Maass, G. Bein, N. Brill, J. F. M. Bechtel, R. Leyh, and H.-H. Sievers Association of Serology With the Endovascular Presence of Chlamydia pneumoniae and Cytomegalovirus in Coronary Artery and Vein Graft Disease Circulation, January 18, 2000; 101(2): 137 - 141. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
B. Lorber Are All Diseases Infectious? Another Look Ann Intern Med, December 21, 1999; 131(12): 989 - 990. [Full Text]
|
|
|
|
|
|
C. J. Wiedermann, S. Kiechl, S. Dunzendorfer, P. Schratzberger, G. Egger, F. Oberhollenzer, and J. Willeit Association of endotoxemia with carotid atherosclerosis and cardiovascular disease: Prospective results from the bruneck study J. Am. Coll. Cardiol., December 1, 1999; 34(7): 1975 - 1981. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 T. Quaschning and C. Wanner The role of Chlamydia in coronary heart disease--fact or fiction? Nephrol. Dial. Transplant., December 1, 1999; 14(12): 2800 - 2803. [Full Text] [PDF]
|
|
| |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||