Evaluation of IFN- γ, Inflammatory Marker And Infectious Etiology As Risk Factors For Coronary Artery Disease

Background: We evaluated the role of Chlamydia pneumoniae ( C. pneumoniae ) and Cytomegalovirus (CMV) infection in coronary artery disease(CAD) patients. Interferon- γ (IFN-γ) levels in serum were assessed for ongoing inflammatory activity by these microorganisms. Methods: Persistent and chronic infection of C. pneumoniae was assessed by the level of IgA and IgG antibodies as well as 16S rRNA gene of C.pneumoniae . Chronic CMV presence was detected by IgG antibodies. IFN-γ levels in serum were analysed by ELISA. Results: Among the 63 CAD cases, C. pneumoniae IgG antibodies were present in 34(53.97%;95% CI: 41.66% to 66.28%) cases, C. pneumoniae IgA antibodies were detected in 42(66.67%; 95% CI :55.03% to78.31%) cases (p<0.05). PCR for detection of C. pneumoniae was done on 40 cases, among which 13 (32.5%; 95% CI: 17.99% to 47.01%) of cases were positive for 16SrRNA gene of C. pneumoniae . CMV IgG was positive in 41 (65.08%; 95% CI: 53.31% to 76.85%) cases. On assessing the patients of CAD for major traditional risk factors,35(55.55%) had past history of CAD, 20(31.75%) of dyslipidemia, 19 (30.16%) gave history of smoking and 18 (28.75%) were obese. On comparison of infectious etiology and traditional risk factors, it was clear that C. pneumoniae and CMV both were more (p<0.001) strongly associated with CAD than the traditional risk factors. Mean level of IFN-γ in these patients was 32.13pg/ml and that of controls was 11.32pg/ml. Raised IFN-γ was observed in 39 (61.9%) patients of which 14 (35.9%) were patients of primary hypertension, 7 (17.9%) were patients of angina and 18 (46.15%) were patients of MI. Conclusions: C. pneumoniae and chronic CMV infection appear to have a role in the pathogenesis of CAD. Elevated IFN-γ levels suggests that these pathogens aggravate the inflammatory process of atherogenesis and hasten the disease process. DOI: 10.21276/APALM.1551