BACKGROUND AND PURPOSE: Serologic evidence of infection with Chlamydia pneumoniae has been associated with cardiovascular disease, but its relationship with stroke risk remains uncertain. The objective of this study is to determine whether serological evidence of C pneumoniae infection is associated with risk of ischemic stroke. METHODS: A population-based case-control study was performed in an urban, multiethnic population. Cases (n=246) had first ischemic stroke, and controls (n=474) matched for age, sex, and race-ethnicity were derived through random-digit dialing. Titers of C pneumoniae-specific IgG and IgA antibodies were measured using microimmunofluorescence, and positive titers were prospectively defined. Conditional logistic regression was used to calculate odds ratios (ORs) and 95% CIs adjusting for medical, behavioral, and socioeconomic factors. RESULTS: Mean age among cases was 72.3+/-9.7 years; 50.8% were women. Elevated C pneumoniae IgA titers were associated with increased risk of ischemic stroke after adjusting for hypertension, diabetes mellitus, current cigarette use, atrial fibrillation, and levels of high-density lipoprotein and low-density lipoprotein (adjusted OR, 1.5; 95% CI, 1.0 to 2.2). Elevated IgG titers were not associated with stroke risk (adjusted OR, 1.2; 95% CI, 0.8 to 1.8). There was a trend toward an association of elevated IgA titers with atherosclerotic and lacunar stroke but less so cardioembolic or cryptogenic subtypes. CONCLUSIONS: Serologic evidence of C pneumoniae infection is associated with ischemic stroke risk. IgA titers may be a better marker of risk than IgG. This association is independent of other stroke risk factors and is present for atherosclerotic, lacunar, and cardioembolic subtypes. Further studies of the effect of C pneumoniae on stroke risk are warranted.
BACKGROUND AND PURPOSE: Serologic evidence of infection with Chlamydia pneumoniae has been associated with cardiovascular disease, but its relationship with stroke risk remains uncertain. The objective of this study is to determine whether serological evidence of C pneumoniae infection is associated with risk of ischemic stroke. METHODS: A population-based case-control study was performed in an urban, multiethnic population. Cases (n=246) had first ischemic stroke, and controls (n=474) matched for age, sex, and race-ethnicity were derived through random-digit dialing. Titers of C pneumoniae-specific IgG and IgA antibodies were measured using microimmunofluorescence, and positive titers were prospectively defined. Conditional logistic regression was used to calculate odds ratios (ORs) and 95% CIs adjusting for medical, behavioral, and socioeconomic factors. RESULTS: Mean age among cases was 72.3+/-9.7 years; 50.8% were women. Elevated C pneumoniae IgA titers were associated with increased risk of ischemic stroke after adjusting for hypertension, diabetes mellitus, current cigarette use, atrial fibrillation, and levels of high-density lipoprotein and low-density lipoprotein (adjusted OR, 1.5; 95% CI, 1.0 to 2.2). Elevated IgG titers were not associated with stroke risk (adjusted OR, 1.2; 95% CI, 0.8 to 1.8). There was a trend toward an association of elevated IgA titers with atherosclerotic and lacunar stroke but less so cardioembolic or cryptogenic subtypes. CONCLUSIONS: Serologic evidence of C pneumoniae infection is associated with ischemic stroke risk. IgA titers may be a better marker of risk than IgG. This association is independent of other stroke risk factors and is present for atherosclerotic, lacunar, and cardioembolic subtypes. Further studies of the effect of C pneumoniae on stroke risk are warranted.
Authors: M S V Elkind; J M Luna; C S Coffey; L A McClure; K M Liu; S Spitalnik; M C Paik; A Roldan; C White; R Hart; O Benavente Journal: Int J Stroke Date: 2010-04 Impact factor: 5.266
Authors: S Janket; J H Meurman; A E Baird; M Qvarnström; P Nuutinen; L K Ackerson; J Hong; P Muthukrishnan; T E Van Dyke Journal: J Dent Res Date: 2010-02-22 Impact factor: 6.116
Authors: Mitchell S V Elkind; Jorge M Luna; Leslie A McClure; Yu Zhang; Christopher S Coffey; Ana Roldan; Oscar H Del Brutto; Edwin Javier Pretell; L Creed Pettigrew; Brett C Meyer; Jorge Tapia; Carole White; Oscar R Benavente Journal: Stroke Date: 2014-02-12 Impact factor: 7.914
Authors: Mitchell S V Elkind; Pankajavalli Ramakrishnan; Yeseon P Moon; Bernadette Boden-Albala; Khin M Liu; Steve L Spitalnik; Tanja Rundek; Ralph L Sacco; Myunghee C Paik Journal: Arch Neurol Date: 2009-11-09
Authors: Mira Katan; Yeseon Park Moon; Myunghee Cho Paik; Ralph L Sacco; Clinton B Wright; Mitchell S V Elkind Journal: Neurology Date: 2013-03-26 Impact factor: 9.910
Authors: Clinton B Wright; Hannah Gardener; Chuanhui Dong; Mitsuhiro Yoshita; Charles DeCarli; Ralph L Sacco; Yaakov Stern; Mitchell S V Elkind Journal: J Am Geriatr Soc Date: 2015-08 Impact factor: 5.562
Authors: Mitchell S V Elkind; Jorge M Luna; Yeseon Park Moon; Bernadette Boden-Albala; Khin M Liu; Steven Spitalnik; Tanja Rundek; Ralph L Sacco; Myunghee C Paik Journal: Stroke Date: 2010-01-14 Impact factor: 7.914