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Journal of Clinical Microbiology, May 2001, p. 1859-1864, Vol. 39, No. 5
0095-1137/01/$04.00+0   DOI: 10.1128/JCM.39.5.1859-1864.2001
Copyright © 2001, American Society for Microbiology. All rights reserved.

Chlamydia pneumoniae Serology: Importance of Methodology in Patients with Coronary Heart Disease and Healthy Individuals

A. Schumacher,1,* A. B. Lerkerød,1 I. Seljeflot,2 L. Sommervoll,1 I. Holme,2 J. E. Otterstad,1 and H. Arnesen2

Department of Microbiology and Department of Medicine, Vestfold Central Hospital, 3116 Tønsberg,1 and Center for Clinical Research and Life Insurance Companies' Institute for Medical Statistics, Ullevål University Hospital, 0407 Oslo,2 Norway

Received 30 October 2000/Returned for modification 30 November 2000/Accepted 2 March 2001

Most publications on the relationship between infection with Chlamydia pneumoniae and coronary heart disease (CHD) propose an association, but negative studies are also reported. Seroepidemiological studies vary in the use of different serological methods, different cutoff limits, different sampling times in relation to acute cardiac events, and different clinical stages of CHD. We wanted to compare three different commercially available methods for measuring Chlamydia antibodies to see how the choice of method influenced the prevalence of seropositive individuals in CHD patients and in healthy individuals and to see if sampling time in relation to an acute cardiac event or the stage of atherothrombotic disease influenced the results. Blood samples from 197 CHD patients and 197 individually matched healthy control individuals were tested at baseline and after 6 months; the mean age was 55 years in both groups, and 18% were women. Among the CHD patients, 166 were included at a median of 16 days after an acute cardiac event and 31 had chronic disease with the latest acute event being >3 months earlier. The difference in prevalence of antibodies between the CHD patients and the healthy controls was significant when Chlamydia lipopolysaccharide antibodies were measured, while no significant differences between the study groups were observed by the two methods detecting Chlamydia pneumoniae major outer membrane protein antibodies. The number of seropositive individuals was quite similar at inclusion and 6 months later, and no significant differences were observed between patients with a recent cardiac event and those with a more remote cardiac event. We conclude that the choice of serological method is of major importance when evaluating a possible relationship between C. pneumoniae and CHD.

* Corresponding author. Mailing address: Department of Microbiology, Vestfold Central Hospital, Halfdan Wilhelmsens allé 17, post box 2168, Postterminalen, 3103 Tønsberg, Norway. Phone: 47 33 342000. Fax: 47 33 343939. E-mail: vssmikro{at}online.no.

Journal of Clinical Microbiology, May 2001, p. 1859-1864, Vol. 39, No. 5
0095-1137/01/$04.00+0   DOI: 10.1128/JCM.39.5.1859-1864.2001
Copyright © 2001, American Society for Microbiology. All rights reserved.


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