DIAGNOSTICS ISSUES OF CHLAMYDOPHILA PNEUMONIAE INFECTION IN PATIENTS WITH ACUTE CORONARY SYNDROME

Abstract

Chlamydophila pneumoniae is nadotrophic to endothelial, smooth muscle cells of blood vessels. Proven ability of the pathogen to initiate atherosclerosis and exacerbate it. The incidence of acute C. pneumoniae infection is higher in patients with acute coronary syndrome than in patients with chronic ischemic heart disease according to the published papers. The aim of the research was the diagnostics of C. pneumoniae infection in patients with acute coronary syndrome by two methods based on different principles. A total of 20 patients admitted to hospital with a preliminary acute coronary syndrome diagnosis. During the first hospital hours of stay based on complaints, medical history, physical examination, results of laboratory and instrumental examination those patients were diagnosed as unstable angina (n = 10) or nontransmural myocardial infarction (n = 10). According to treatment standart all patients underwent coronary angiography and angioplasty. Furthermore, these patients fulfilled fence of the clinical material as mucosal scrapings nasal passages and posterior wall of the oropharynx applied on glass slides. Also, there were samples of arterial blood smears, obtained from the conductors installed in the locations pointed to implement the coronary arteries and angioplasty. These samples were examined by indirect immunofluorescence with the form of specific monoclonal antibodies against the cell wall major outer membrane protein of C. pneumoniae. Serum was used for immunoassay to quantify classes A and G immunoglobulins against C. pneumoniae. When comparing the results of two diagnostics methods of C. pneumoniae chronic infection, it was diagnosed in 5 of the 20 patients studied. One patient was with unstable angina and 4 were with nontransmural myocardial infarction. The presence of acute infection C. pneumoniae has been proven in 9 of 20 patients, including 4 patients with unstable angina and 5 with nontransmural myocardial infarction. Also found that patients with acute coronary syndrome, the infection can occur both by seropositive and seronegative types. Thus, acute coronary syndrome may be associated with chronic or acute infection of C. pneumoniae. The relevance of further study of the infection in patients with atherosclerosis was confirmed once again.

Keywords

• unstable angina
• nontransmural myocardial infarction
• chlamydophila pneumoniae infection
• diagnostic
• indirect immunofluorescence
• enzyme immunoassay