Individual pathogens, pathogen burden and markers of subclinical atherosclerosis: The Multi-Ethnic Study of Atherosclerosis

Moyses Szklo, Jingzhong Ding, Michael Y. Tsai, Mary Cushman, Joseph F. Polak, João Lima, R. Graham Barr, A. Richey Sharrett

Research output: Contribution to journalArticlepeer-review

34 Scopus citations


Methods: We examined the cross-sectional relationships of subclinical atherosclerosis - expressed by carotid intimal-medial thickness and coronary calcification - with antibodies to Chlamydia pneumoniae, Helicobacter pylori, cytomegalovirus, herpes simplex virus, hepatitis A virus, and pathogen burden (number of positive pathogens). A random sample of 1056 individuals chosen from 5030 Multi-Ethnic Study of Atherosclerosis cohort participants were included. RESULTS: After multiple adjustment, no associations were found between atherosclerosis measures and either individual pathogens or pathogen burden. Interactions with inflammatory and endothelial function markers, demographic factors, BMI, high-density lipoprotein, diabetes, and smoking were also explored. The only interaction that was large, qualitative, statistically significant (P < 0.05) and in the expected direction was that between hepatitis A virus and soluble intercellular adhesion molecule-1 with regard to Agatston calcium score: the difference between hepatitis A virus-positive and hepatitis A virus-negative participants was -186 units in participants with soluble intercellular adhesion molecule-1 below the median, and +162 units in those with soluble intercellular adhesion molecule-1 equal or above the median. However, given the number of interactions that were explored, these results must be interpreted cautiously. CONCLUSION: Findings from the present analyses do not provide support for an infectious etiology for subclinical atherosclerosis. However, the study's limitations, which include its cross-sectional design and insufficient statistical power, suggest that inferences from its findings should be made cautiously.

Original languageEnglish (US)
Pages (from-to)747-751
Number of pages5
JournalJournal of Cardiovascular Medicine
Issue number10
StatePublished - Oct 2009


  • Atherosclerosis; infections; pathogens


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