To test the hypothesis that chronic infection with
Chlamydia pneumoniae, Helicobacter pylori or
cytomegalovirus is associated with coronary heart disease
risk in elderly men, a nested case-control study in a cohort
investigated in 1985 and 1990 in the town of Zutphen, The
Netherlands, was designed. Fifty-four cases with a first
diagnosed coronary event between 1985
and 1990, and 108 age-matched control subjects free of coronary
heart disease during follow
up were included in the study. The overall prevalence of
antibodies to cytomegalovirus was
74·7%, to H. pylori 75·9% and to
C. pneumoniae 84·0%. A high level of antibodies
to C. pneumoniae was associated with an increased
coronary heart disease risk (OR=2·76; 95%
CI=1·31–5·81). This association was
stronger in cases developing both myocardial infarction
and angina pectoris, than in cases developing only one of
these. This association was
independent of potential confounders. Antibodies to
cytomegalovirus or H. pylori were not
associated with coronary heart disease risk. These results
support the hypothesis of a role of
chronic C. pneumoniae infections in the
immunopathogenesis of atherosclerosis.