Chronic infections and coronary heart disease.

The rapidly changing patterns of coronary heart disease (CHD) prevalence and presentation fail to be explained by conventional cardiovascular risk factors alone. An infectious basis to atherosclerosis may, at least in part, be contributing to the variable rates of prevalence of CHD in different parts of the world. The evidence for such an association appears to be strongest for Chlamydia pneumoniae. Results of recent anti-chlamydia antibiotic intervention pilot studies have renewed interest in the role of C. pneumoniae, and corroborated the evidence from sero-epidemiological, pathological and animal-model studies. The results of larger, on-going, purpose-designed intervention studies should help to increase our understanding of the role of infection in atherogenesis and potentially lead to a novel and effective treatment strategy for patients with CHD--broad spectrum antibiotics.