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Chlamydia pneumoniae and the risk of first ischemic stroke : The Northern Manhattan Stroke Study.
Stroke 2000; 31(7):1521-5S

Abstract

BACKGROUND AND PURPOSE

Serological evidence of infection with Chlamydia pneumoniae has been associated with cardiovascular disease in multiple epidemiological studies. The data on its association with ischemic stroke are limited. We sought to determine whether chronic C pneumoniae infection is associated with ischemic stroke in a multi-ethnic population.

METHODS

The Northern Manhattan Stroke Study contains a population-based, case-control study component. Cases had first ischemic stroke and matched control subjects were derived through random digit dialing. Titers of IgG, IgA, and IgM antibodies specific for C pneumoniae were measured with the use of microimmunofluorescence, and titers >/=1:16 were considered positive. Conditional logistic regression was used to calculate odds ratios (ORs) and 95% confidence intervals (95% CIs) after adjustment for medical, behavioral, and socioeconomic factors.

RESULTS

Eighty-nine cases and 89 control subjects were selected. Mean age among cases was 68.5+/-12.8 years; 53% were women and 15% of the subjects were white, 28% were black, and 54% were Hispanic. Elevated C pneumoniae IgA titers were significantly associated with risk of ischemic stroke after adjusting for other stroke risk factors (adjusted OR 4. 51, 95% CI 1.44 to 14.06). IgG titers were less strongly associated with stroke risk (adjusted OR 2.59, 95% CI 0.87 to 7.75). The association of IgA with stroke risk was detected in both younger and older groups, in men and women, and in whites, blacks, and Hispanics. There was also a significant continuous increase in risk associated with the log-transformation of the titer for IgA (adjusted OR 1.32, 95% CI 1.05 to 1.66) but not IgG.

CONCLUSIONS

Serological evidence of chronic infection with C pneumoniae is associated with risk of ischemic stroke in an urban, multi-ethnic population. IgA titers may be a better marker of this risk than are IgG titers. This association is independent of other vascular disease risk factors. Further prospective epidemiological studies of the effect of this infection on stroke risk are warranted.

Authors+Show Affiliations

Department of Neurology, College of Physicians and Surgeons, Columbia University, and the Columbia-Presbyterian Medical Center of New York Presbyterian Hospital, New York, NY, USA. mse13@columbia.eduNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

10884447

Citation

Elkind, M S., et al. "Chlamydia Pneumoniae and the Risk of First Ischemic Stroke : the Northern Manhattan Stroke Study." Stroke, vol. 31, no. 7, 2000, pp. 1521-5.
Elkind MS, Lin IF, Grayston JT, et al. Chlamydia pneumoniae and the risk of first ischemic stroke : The Northern Manhattan Stroke Study. Stroke. 2000;31(7):1521-5.
Elkind, M. S., Lin, I. F., Grayston, J. T., & Sacco, R. L. (2000). Chlamydia pneumoniae and the risk of first ischemic stroke : The Northern Manhattan Stroke Study. Stroke, 31(7), pp. 1521-5.
Elkind MS, et al. Chlamydia Pneumoniae and the Risk of First Ischemic Stroke : the Northern Manhattan Stroke Study. Stroke. 2000;31(7):1521-5. PubMed PMID: 10884447.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Chlamydia pneumoniae and the risk of first ischemic stroke : The Northern Manhattan Stroke Study. AU - Elkind,M S, AU - Lin,I F, AU - Grayston,J T, AU - Sacco,R L, PY - 2000/7/8/pubmed PY - 2000/8/6/medline PY - 2000/7/8/entrez SP - 1521 EP - 5 JF - Stroke JO - Stroke VL - 31 IS - 7 N2 - BACKGROUND AND PURPOSE: Serological evidence of infection with Chlamydia pneumoniae has been associated with cardiovascular disease in multiple epidemiological studies. The data on its association with ischemic stroke are limited. We sought to determine whether chronic C pneumoniae infection is associated with ischemic stroke in a multi-ethnic population. METHODS: The Northern Manhattan Stroke Study contains a population-based, case-control study component. Cases had first ischemic stroke and matched control subjects were derived through random digit dialing. Titers of IgG, IgA, and IgM antibodies specific for C pneumoniae were measured with the use of microimmunofluorescence, and titers >/=1:16 were considered positive. Conditional logistic regression was used to calculate odds ratios (ORs) and 95% confidence intervals (95% CIs) after adjustment for medical, behavioral, and socioeconomic factors. RESULTS: Eighty-nine cases and 89 control subjects were selected. Mean age among cases was 68.5+/-12.8 years; 53% were women and 15% of the subjects were white, 28% were black, and 54% were Hispanic. Elevated C pneumoniae IgA titers were significantly associated with risk of ischemic stroke after adjusting for other stroke risk factors (adjusted OR 4. 51, 95% CI 1.44 to 14.06). IgG titers were less strongly associated with stroke risk (adjusted OR 2.59, 95% CI 0.87 to 7.75). The association of IgA with stroke risk was detected in both younger and older groups, in men and women, and in whites, blacks, and Hispanics. There was also a significant continuous increase in risk associated with the log-transformation of the titer for IgA (adjusted OR 1.32, 95% CI 1.05 to 1.66) but not IgG. CONCLUSIONS: Serological evidence of chronic infection with C pneumoniae is associated with risk of ischemic stroke in an urban, multi-ethnic population. IgA titers may be a better marker of this risk than are IgG titers. This association is independent of other vascular disease risk factors. Further prospective epidemiological studies of the effect of this infection on stroke risk are warranted. SN - 0039-2499 UR - https://www.unboundmedicine.com/medline/citation/10884447/Chlamydia_pneumoniae_and_the_risk_of_first_ischemic_stroke_:_The_Northern_Manhattan_Stroke_Study_ L2 - http://www.ahajournals.org/doi/full/10.1161/01.str.31.7.1521?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -