Coronary artery disease: an inflammatory or infectious process.

It is well accepted that coronary artery disease is linked to an inflammatory process. It is unknown which agents may cause or accelerate coronary artery disease. An inflammation of the vessel wall may be caused by a number of mechanisms such as accumulation of glycosylated proteins in diabetic patients, oxidised LDL in patients with hypercholesterolemia or infectious agents. Among the possible infectious agents Chlamydia pneumoniae is the most likely microorganism involved in atherosclerosis. The arguments in favour of Chlamydia pneumoniae result from seroepidemiologic studies and from detection of chlamydial DNA in atherosclerotic plaques by polymerase chain reaction (PCR). In addition this microorganism is the only one that could be isolated from atherosclerotic tissue. This review summarises the present understanding of the role of an inflammatory process in the development or progression of coronary artery disease.