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Heart disease patients who have had a
greater exposure to bacteria and viruses tend to have more
clogging in their arteries and a worse prognosis than patients
exposed to fewer infectious agents.
The finding adds to the growing body of
evidence that inflammation and infection play a key role in
the development of atherosclerosis, the clogging of arteries
that can lead to heart attacks.
Their study included 572 patients who
were admitted to the hospital for cardiac catheterization,
a technique used to locate blockages in arteries in people
who have had a heart attack or who are at risk for one.
All the patients were tested for antibodies
-- a sign of past infection -- to several bacteria and viruses,
including herpes simplex virus 1 and 2, cytomegalovirus, Epstein-Barr
virus, Haemophilus influenzae, Chlamydia pneumoniae, Mycoplasma
pneumoniae and Helicobacter pylori.
Over the next three years or so, the researchers
found that patients who had four to five past infections were
nearly twice as likely to have extensive clogging in the arteries
as those with fewer infections. Patients with six to eight
past infections were 2 to 3 times as likely to have advanced
heart disease as those with fewer infections.
During the study, the cardiovascular death
rate was 7% for patients with advanced atherosclerosis with
zero to three infections and 20% for those with advanced atherosclerosis
and six to eight infections.
The researchers demonstrated that increasing
numbers of infectious pathogens were significantly related
to the extent of atherosclerosis and to adverse long-term
outcome.
Circulation
January 8, 2002;105:2-4,15-21
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