Joint effects of Chlamydia pneumoniae infection and classic coronary risk factors on risk of acute myocardial infarction |
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Authors: | Kinjo Kunihiro,Sato Hiroshi,Sato Hideyuki,Ohnishi Yozo,Hishida Eiji,Nakatani Daisaku,Mizuno Hiroya,Ohgitani Nobuhisa,Kubo Mitsuaki,Shimazu Takashi,Akehi Noriyuki,Takeda Hiroshi,Hori Masatsugu Osaka Acute Coronary Insufficiency Study Group |
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Affiliation: | a Department of Internal Medicine and Therapeutics, Osaka University Graduate School of Medicine, Suita, Japan b Kita-Osaka Hospital, Osaka, Japan c Sumitomo Life Multiphasic Health Test System, Osaka, Japan d Kobe Ekisaikai Hospital, Kobe, Japan e Settsu Iseikai Hospital, Settsu, Japan f Department of Medical Information Science, Osaka University Graduate School of Medicine, Suita, Japan |
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Abstract: | BackgroundAlthough not in itself strongly predictive of coronary heart disease, Chlamydia pneumoniae infection could interact with classic risk factors in determining risk of acute myocardial infarction (AMI).MethodsWe assessed C pneumoniae immunoglobulin (Ig) G and IgA titers and classic risk factors in 618 patients with AMI and in 967 controls.ResultsIgG titers were not related to AMI, but a significant association was seen between IgA titers and AMI. Excess risk of AMI was noted mainly among patients with the highest IgA titers, such as those beyond 2.88 (the 95th percentile cutoff point in control subjects), showing a 1.8-fold increase in risk (odds ratio 1.75, 95% CI 1.04-2.92). Classic risk factors did not differ between subjects with IgA titers above and below the 95th percentile cutoff. However, in multivariate analyses, models incorporating both IgA titers and a classic risk factor such as obesity, hypercholesterolemia, or smoking predicted risk more effectively than single-parameter models. For example, the odds ratio for AMI among subjects with the highest IgA titers plus hypercholesterolemia was greater than the product of individual risks associated with these high IgA titers and with hypercholesterolemia.ConclusionsInteractions with classic risk factors (ie, obesity, hypercholesterolemia, and smoking), increased the predictive value of C pneumoniae IgA antibody titers in determining risk of AMI. |
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