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CLINICAL STUDIES

The prevalence of Chlamydia pneumoniae in atherosclerotic and nonatherosclerotic blood vessels of patients attending for redo and first time coronary artery bypass graft surgery

Yuk-ki Wong, BSc, MB, (Hons), ChB, MRCP^* , Martine Thomas, PhD^*, Victor Tsang, FRCS , Patrick J. Gallagher, MD, PhD, FRCP and Michael E. Ward, PhD^*

^* Molecular Microbiology, Southampton University Medical School, Southampton, England, United Kingdom
Wessex Cardiothoracic Unit, Southampton General Hospital, Southampton, England, United Kingdom
Present address: Great Ormond Street Children’s Hospital, London, England, United Kingdom
Department of Pathology, Southampton General Hospital, Southampton, England, United Kingdom

Manuscript received August 17, 1998; revised manuscript received August 18, 1998, accepted September 24, 1998.

Address for correspondence: Dr. Yuk-ki Wong, Wessex Cardiothoracic Unit, Southampton General Hospital, Tremona Road, Southampton, England, United Kingdom S016 6YD
YW2{at}soton.ac.uk

Objectives. To determine if Chlamydia pneumoniae (C. pneumoniae) is more prevalent in atherosclerotic compared with normal blood vessels of patients requiring redo and first time coronary artery bypass graft surgery (CABG).

Background. Serological and pathological studies have associated atherosclerosis with C. pneumoniae infection. As atherosclerosis is one of the causes of graft failure following CABG, then it may be expected that the prevalence of the organism in failed grafts and diseased native vessels should be greater than in the new grafts.

Methods. Endarterectomy specimens and failed and new grafts were collected from 49 patients with late graft failure. Endarterectomy specimens and new grafts were also collected from nine patients having first time CABG. The presence of C. pneumoniae DNA was then checked for using a nested polymerase chain reaction.

Results. The prevalence of C. pneumoniae DNA in failed venous grafts (38.2%) was similar to that in endarterectomy specimens from native coronary arteries (38.5%) and greater than that in new saphenous vein grafts (11.8%). However, it was similar to that in new internal mammary artery grafts (30.0%). Also, the interval between surgery in redo patients was the same regardless of whether C. pneumoniae was present or not.

Conclusions. Cross sectional studies cannot determine whether C. pneumoniae is a cause of atherosclerosis since they do not show whether infection precedes or follows its development. However, our results suggest that the organism is not an important factor in graft failure or atherosclerosis.

Abbreviations and Acronyms   CABG = Coronary artery bypass graft surgery   ICC = immunocytochemistry   IMA = internal mammary artery   PCR = polymerase chain reaction   SV = saphenous vein

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