Heart 1999;81:245-247 ( March )

Chronic infection with Helicobacter pylori, Chlamydia pneumoniae, or cytomegalovirus: population based study of coronary heart disease

J Danesh,^a Y Wong,^b M Ward,^b J Muir^c

^a Clinical Trial Service Unit and Epidemiological Studies Unit, Radcliffe Infirmary, Oxford OX2 6HE, UK, ^b Department of Cardiology and Molecular Microbiology, Southampton University Medical School, Southampton, UK, ^c ICRF General Practice Research Group, Division of Public Health and Primary Care, Institute of Health Sciences, Oxford, UK

Correspondence to: Dr Danesh. email: john.danesh{at}balliol.ox.ac.uk

Accepted for publication 4 November 1998

OBJECTIVETo study possible associations between coronary heart disease and serological evidence of persistent infection with Helicobacter pylori, Chlamydia pneumoniae, or cytomegalovirus.
DESIGNPopulation based, case-control study, nested within a randomised trial.
SETTINGFive general practices in Bedfordshire, UK.
INDIVIDUALS288 patients with incident or prevalent coronary heart disease and 704 age and sex matched controls.
RESULTSHigh concentrations of serum IgG antibodies to H pylori were present in 54% of cases v 46% of controls, with corresponding results for C pneumoniae seropositivity (33% v 33%), and cytomegalovirus seropositivity (40% v 31%). After adjustments for age, sex, smoking, indicators of socioeconomic status, and standard risk factors, the odds ratios (95% confidence intervals) for coronary heart disease of seropositivity to these agents were: 1.28 (0.93 to 1.75) for H pylori, 0.95 (0.66 to 1.36) for C pneumoniae, and 1.40 (0.96 to 2.05) for cytomegalovirus.
CONCLUSIONSThere is no good evidence of strong associations between coronary heart disease and serological markers of persistent infection with H pylori, C pneumoniae, or cytomegalovirus. To determine the existence of moderate associations between these agents and disease, however, larger scale studies will be needed that can keep residual confounders to a minimum.

Keywords: ischaemic heart disease; Helicobacter pylori; Chlamydia pneumoniae; cytomegalovirus

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© 1999 by Heart
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