Advertisement
ADVANCED SEARCH

This Article Full Text Full Text (PDF) Submit a response Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Fong, I. W. Search for Related Content PubMed PubMed Citation Articles by Fong, I. W. Related Collections Ischemic heart disease Drugs: infections

Emerging relations between infectious diseases and coronary artery disease and atherosclerosis

Dr. Fong is with the Division of Infectious Diseases, Department of Medicine, St. Michael's Hospital and University of Toronto, Toronto, Ont.

Abstract

Cardiovascular disease is the leading cause of death in developed countries. The cause is multifactorial. A substantial proportion of patients with coronary artery disease (CAD) do not have traditional risk factors. Infectious diseases may play a role in these cases, or they may intensify the effect of other risk factors. The association of CAD and Chlamydia pneumoniae infection is firmly established, but causality is yet to be proven. The link with other infectious agents or conditions, such as cytomegalovirus, herpes simplex virus, Helicobacter pylori and periodontitis, is more controversial. Cytomegalovirus infection is more strongly linked than native CAD to coronary artery restenosis after angioplasty and to accelerated CAD after cardiac transplantation. However, new data on this topic are appearing in the literature almost every month. The potential for novel therapeutic management of cardiovascular disease and stroke is great if infection is proven to cause or accelerate CAD or atherosclerosis. However, physicians should not "jump the gun" and start using antibiotic therapy prematurely for CAD. The results of large randomized clinical trials in progress will help establish causality and the benefits of antimicrobial therapy in CAD.

This article has been cited by other articles:

				F. Apostolou, I. F. Gazi, A. Kostoula, C. C. Tellis, A. D. Tselepis, M. Elisaf, and E. N. Liberopoulos Persistence of an atherogenic lipid profile after treatment of acute infection with brucella J. Lipid Res., December 1, 2009; 50(12): 2532 - 2539. [Abstract] [Full Text] [PDF]

				F J. Nieto Commentary: Understanding the pathophysiology of poverty Int. J. Epidemiol., June 1, 2009; 38(3): 787 - 790. [Full Text] [PDF]

				R. T. Demmer and M. Desvarieux Periodontal infections and cardiovascular disease: The heart of the matter J Am Dent Assoc, October 1, 2006; 137(suppl_2): 14S - 20S. [Abstract] [Full Text] [PDF]

				L. Robman, O. Mahdi, C. McCarty, P. Dimitrov, G. Tikellis, J. McNeil, G. Byrne, H. Taylor, and R. Guymer Exposure to Chlamydia pneumoniae Infection and Progression of Age-related Macular Degeneration Am. J. Epidemiol., June 1, 2005; 161(11): 1013 - 1019. [Abstract] [Full Text] [PDF]

				L. L. Stoll, G. M. Denning, and N. L. Weintraub Potential Role of Endotoxin as a Proinflammatory Mediator of Atherosclerosis Arterioscler Thromb Vasc Biol, December 1, 2004; 24(12): 2227 - 2236. [Abstract] [Full Text] [PDF]

				V. Dhawan, Z. L.S. Brookes, and S. Kaufman Long-term effects of repeated pregnancies (multiparity) on blood pressure regulation Cardiovasc Res, October 1, 2004; 64(1): 179 - 186. [Abstract] [Full Text] [PDF]

				L. L. Stoll, G. M. Denning, W.-G. Li, J. B. Rice, A. L. Harrelson, S. A. Romig, S. T. Gunnlaugsson, F. J. Miller Jr, and N. L. Weintraub Regulation of Endotoxin-Induced Proinflammatory Activation in Human Coronary Artery Cells: Expression of Functional Membrane-Bound CD14 by Human Coronary Artery Smooth Muscle Cells J. Immunol., July 15, 2004; 173(2): 1336 - 1343. [Abstract] [Full Text] [PDF]

				G. A. Modest and J. Kaufmann Antibiotics and Coronary Heart Disease JAMA, January 21, 2004; 291(3): 302 - 302. [Full Text] [PDF]

				J. D. Spence and J. Norris Infection, Inflammation, and Atherosclerosis Stroke, February 1, 2003; 34(2): 333 - 334. [Full Text] [PDF]

				M. Smieja, J. Gnarpe, E. Lonn, H. Gnarpe, G. Olsson, Q. Yi, V. Dzavik, M. McQueen, S. Yusuf, and for the Heart Outcomes Prevention Evaluation (HOPE Multiple Infections and Subsequent Cardiovascular Events in the Heart Outcomes Prevention Evaluation (HOPE) Study Circulation, January 21, 2003; 107(2): 251 - 257. [Abstract] [Full Text] [PDF]

				I. W. FONG Infections and their role in atherosclerotic vascular disease J Am Dent Assoc, June 1, 2002; 133(suppl_1): 7S - 13S. [Abstract] [Full Text] [PDF]

				D. G. Alber, P. Vallance, and K. L. Powell Enhanced Atherogenesis Is Not an Obligatory Response to Systemic Herpesvirus Infection in the ApoE-Deficient Mouse: Comparison of Murine {gamma}-Herpesvirus-68 and Herpes Simplex Virus-1 Arterioscler Thromb Vasc Biol, May 1, 2002; 22(5): 793 - 798. [Abstract] [Full Text] [PDF]

HOME	CURRENT ISSUE	PAST ISSUES	COLLECTIONS	HELP	SEARCH
Copyright 1995-2000, Canadian Medical Association. All rights reserved. ISSN 1488-2329 (e) 0820-3946 (p) All editorial matter in CMAJ represents the opinions of the authors and not necessarily those of the Canadian Medical Association.