OBJECTIVETo evaluate the relationship between infection burden and coronary atherosclerosis and the plaque feature.

METHODSOne hundred and eighty two patients underwent coronary angiography in Zhongshan Hospital from 2002 - 2003. Atherosclerosis and vulnerable plaque were determined by intravascular ultrasound (IVUS). Seropositivity of cytomegalovirus, helicobacter pylori, chlamydia pneumonia, hepatitis B virus, EB virus, CoxB virus, influenza A virus, influenza B virus and mycobacterium tuberculosis were determined by ELISA. The serum hs-CRP was detected by Dade Behring prospect (Immuno-nehelomitery). Patients were divided into three groups according to the pathogen burden: group A, n or= 6.

RESULTSThe pathogen burden was independent of the C-reactive protein level. Increasing pathogen burden was significantly associated with increasing atherosclerosis risk, the prevalence of atherosclerosis was 44.4%, 70.6% and 76.7% in group A, B and C. The risk associated with elevated pathogen burden was much higher when CRP was also elevated (> 5.0 mg/L) (43.8%, 70.0%, 70.8%) vs (45.5%, 63.7%, 96.8%). The positively of vulnerable plaque increased significantly when the pathogen burden was high (n > 5) (33.3%, 32.4% and 51.7% P < 0.05).

CONCLUSIONOur data suggested that infection burden was associated with prevalence of coronary atherosclerosis, and it was particularly important when C-reactive protein was elevated. The high level infection burden could predict vulnerable plaque.