Where is the link between atherosclerosis and C. pneumoniae?
A hint for a link between C. pneumoniae and atherosclerosis first came from seroepidemiological studies from Finland [5]. Meanwhile a number of studies have shown associations between C. pneumoniae seropositivity and atherosclerosis either of the carotid arteries or of the coronary circulation [6,7]. These studies were retrospective and cross-sectional, however, and thus fail to provide definite proof. Although a high prevalence of anti-chlamydial antibodies has consistently been found in patients with ischaemic heart disease, the predictive value is limited given the high level of exposure in the general adult population [8]. For the same reason the issue of causality remains unresolved, since anti-chlamydial antibodies are found in 50% of the middle aged population. Furthermore, two recent studies revealed conflicting results: while an association of seropositivity for C. pneumoniae with an increased risk of future cardiovascular disease could be demonstrated in hypertensive patients
