To review the role of Chlamydia pneumoniae in the pathogenesis of
coronary heart disease (CHD).
Data Sources:
Articles indexed in MEDLINE from 1966 to April 1998 as well as references
identified in these articles were searched.
Data Extraction:
Studies investigating seroepidemiologic and pathologic evidence for an association
of C. pneumoniae with CHD and randomized clinical trials
evaluating the effectiveness of antibiotic therapy on cardiovascular outcomes are
presented.
Data Synthesis:
Seroepidemiologic and pathologic studies provide circumstantial evidence of an
association between C. pneumoniae and CHD. Results of initial
small trials suggest a reduction in CHD events in patients treated with macrolide
antibiotics.
Conclusions:
Direct evidence implicating chlamydial infection in CHD is lacking. Formal
recommendations for antimicrobial therapy should not be made until results of
additional clinical trials are available.
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