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September 17, 2003

Antibiotic Therapy for Coronary Artery Disease: Can a WIZARD Change It All?

Author Affiliations

Author Affiliations: Department of Cardiology, Mayo Clinic and Foundation, Rochester, Minn (Dr Pislaru) and Department of Cardiology, Gasthuisberg University Hospital and University of Leuven, Leuven, Belgium (Dr Van de Werf).

JAMA. 2003;290(11):1515-1516. doi:10.1001/jama.290.11.1515

The possible association between Chlamydia pneumoniae and atherosclerosis was first reported in 1988 by Saikku et al1 who noted that antichlamydial antibodies were present more often among patients with acute myocardial infarction (MI) than among matched controls. Since then, several other serological studies have yielded conflicting results about this association, possibly due to lack of uniformity in methods used (ie, different classes of antibodies tested, different methods, different cutoff points) and by the high prevalence of C pneumoniae exposure in the population. On the other hand, data from basic laboratory studies have strongly suggested a possible role of C pneumoniae in the etiology of atherosclerosis. Cells involved in atherogenesis (vascular endothelial cells, smooth muscle cells, macrophages, and platelets) have been found to be infected by C pneumoniae.2 In mouse and rabbit models, C pneumoniae has been detected in the vasculature after nasal inoculation and has been associated with various degrees of atherogenesis and progression.2Chlamydia pneumoniae also has been documented in atherosclerotic lesions from patients.2