Infectious Burden and Carotid Plaque Thickness: the Northern Manhattan Study

Overview

Journal Stroke

Specialties Cardiology & Vascular Diseases
Neurology

Date 2010 Jan 16

PMID 20075350

Citations 39

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

Affiliations

Soon will be listed here.

Abstract

Background And Purpose: The overall burden of prior infections may contribute to atherosclerosis and stroke risk. We hypothesized that serological evidence of common infections would be associated with carotid plaque thickness in a multiethnic cohort.

Methods: Antibody titers to 5 common infectious microorganisms (ie, Chlamydia pneumoniae, Helicobacter pylori, cytomegalovirus, and herpesvirus 1 and 2) were measured among stroke-free community participants and a weighted index of infectious burden was calculated based on Cox models previously derived for the association of each infection with stroke risk. High-resolution carotid duplex Doppler studies were used to assess maximum carotid plaque thickness. Weighted least squares regression was used to measure the association between infectious burden and maximum carotid plaque thickness after adjusting for other risk factors.

Results: Serological results for all 5 infectious organisms were available in 861 participants with maximum carotid plaque thickness measurements available (mean age, 67.2+/-9.6 years). Each individual infection was associated with stroke risk after adjusting for other risk factors. The infectious burden index (n=861) had a mean of 1.00+/-0.35 SD and a median of 1.08. Plaque was present in 52% of participants (mean, 0.90+/-1.04 mm). Infectious burden was associated with maximum carotid plaque thickness (adjusted increase in maximum carotid plaque thickness 0.09 mm; 95% CI, 0.03 to 0.15 mm per SD increase of infectious burden).

Conclusions: A quantitative weighted index of infectious burden, derived from the magnitude of association of individual infections with stroke, was associated with carotid plaque thickness in this multiethnic cohort. These results lend support to the notion that past or chronic exposure to common infections, perhaps by exacerbating inflammation, contributes to atherosclerosis. Future studies are needed to confirm this hypothesis and to define optimal measures of infectious burden as a vascular risk factor.

Citing Articles

Childhood infection burden, recent antibiotic exposure and vascular phenotypes in preschool children.

Yu A, Jansen M, Dalmeijer G, Bruijning-Verhagen P, van der Ent C, Grobbee D PLoS One. 2023; 18(9):e0290633.

PMID: 37713433 PMC: 10503770. DOI: 10.1371/journal.pone.0290633.

Exosomes in atherosclerosis: Convergence on macrophages.

Yang K, Xiao Q, Niu M, Pan X, Zhu X Int J Biol Sci. 2022; 18(8):3266-3281.

PMID: 35637946 PMC: 9134907. DOI: 10.7150/ijbs.71862.

Association of Infection With Carotid Atherosclerosis in a Northern Chinese Population: A Cross-Sectional Study.

Zhang P, He Q, Song D, Wang Y, Liu X, Ding G Front Cardiovasc Med. 2022; 8:795795.

PMID: 35174222 PMC: 8841728. DOI: 10.3389/fcvm.2021.795795.

Intracranial Large Artery Stenosis and Past Infectious Exposures: Results From the NOMAS Cohort.

Mehta A, Khasiyev F, Wright C, Rundek T, Sacco R, Elkind M Stroke. 2022; 53(5):1589-1596.

PMID: 35105181 PMC: 9038664. DOI: 10.1161/STROKEAHA.121.036793.

From the Heart to the Brain: Building Bridges to a Better Future.

Elkind M Stroke. 2022; 53(3):1037-1042.

PMID: 35012329 PMC: 8885844. DOI: 10.1161/STROKEAHA.121.036763.

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