CHLAMYDIA INFECTION, SEVERITY OF CORONARY ATHEROSCLEROSIS AND IMMUNE STATUS IN PATIENTS WITH STABLE ANGINA

Lomakovsky A.N., Gavrilenko T.I., Pidgaina O.A., Lutay M.I.

• SI «NSC «Institute of Cardiology M.D. Strazhesko» NAMS of Ukraine», Kyiv

Summary. Introduction. An epidemiological relationship between seropositivity to various infectious agents and the incidence of ischemic heart disease is shown. The presence of pathogenic organisms in progressive atherosclerotic plaques has been proven. A positive association was found between Chlamydia pneumonia and the risk of coronary heart disease. The aim of the study was to assess the relationship of Chlamydia infection with the severity of coronary atherosclerosis, the course of ischemic heart disease, with the state of cellular and humoral acquired and innate immunity in order to understand the mechanisms of the possible effect of Chlamydia infection on the development of atherosclerosis. Object and research methods. 139 patients with stable coronary artery disease with and without Chlamydia infection were examined. The material for the immunological study was peripheral venous blood. To determine the parameters of cellular and humoral innate and adaptive immunity in blood serum and supernatants of mononuclear cells, enzyme immunoassay was used. Research results. Between patients with coronary heart disease with chlamydial infection compared with patients without it, the level of CRP was 6.5 (3.3–12.4) versus 4.7 (2.1–7.9) mg/l (p=0.024) (R=0.26; p=0.029), the activity of ballast transformation of lymphocytes with non-specific antigen PHA — 49 (41–53) against 43 (40–50)% (p=0.054) (R=0.27; p=0.005), oxygen-dependent metabolism of neutrophils by spontaneous HCT test was respectively 62 (49–70) against 52 (41–64)% (p=0.004) (R=0.18;p=0.034), the number of neutrophils with negative activation — 56 (48–62) vs. 43 (30–53)% (p=0.028). The clinical characteristics of patients with chronic coronary heart disease with the presence of chlamydial infection compared with patients without it did not differ in quantitative coronary artery disease according to G.G. Gensini — 54 (20–89) against 35 (25–79) points (p=0.30), the presence of multivascular coronary lesions — in 70 against 75% of patients (p=0.18), the presence of postinfarction cardiosclerosis — in 45 against 51% of patients (p=0.56), the presence of CHF stage IIa and above — in 6 vs. 3% (p=0.77). Conclusions. The presence of Chlamydia infection, compared with its absence in patients with stable coronary artery disease, is accompanied by increased levels of C-reactive blood protein, high activity of blast transformation of T-lymphocytes and blood neutrophils without functional changes in monocytes. The presence of Chlamydia infection is not associated with endothelial dysfunction, activity of lipid peroxidation and apoB proteins, expressiveness of coronary atherosclerosis, clinical manifestations of coronary artery disease and the development of complications (myocardial infarction, heart failure).