Childhood contagious diseases (n=6) had a protecting effect against CHD (odds ratio 0.86, p=0.013). The risk for acute coronary events decreased significantly with increasing number of childhood contagious diseases (p=0.007).Conclusions. Infections have a dual role in the genesis of CHD.

Elevated microbial titres, indicating an on-going inflammation, were associated with cardiovascular events. MBL might have a dual role both decreasing susceptibility to infections and increasing the risk of acute coronary syndromes.

Abstract:Background: The etiology and significance of flu-like symptoms often appearing before myocardial infarction should be clarified. Methods: In a case-control study of 323 matched controls and a random sample of 110 out of 351 cases the presence of infection symptoms during the preceding four weeks before admission were asked and blood samples taken. Results: Enterovirus (EV), herpes simplex virus (HSV), and Chlamydia pneumoniae IgA titers were significantly higher in cases than in controls (p50.001, 0.008 and 0.046, respectively). Flu-like symptoms appeared significantly more often in patients than in controls the most common one being fatigue (p50.001). In controls with fatigue, EV and HSV titers showed a trend to be higher (1.50 vs 1.45 and 4.29 vs 3.73) than in controls without fatigue but only HSV titers were statistically significantly higher (3.47 vs 3.96, p ¼ 0.02). Even CRP and amyloid A concentrations (3.49 vs 2.08, p50.0001 and 5.70 vs 3.77 mg/l, p ¼ 0.003, respectively) as well as C4 (0.40 vs 0.44, p ¼ 0.02) were higher in controls with fatigue. Conclusions: Odds ratios for a coronary event in a logistic regression model were 4.79 for fatigue and 2.72 for EV antibody levels in their fourth quartile. A linear-by-linear association test showed increasing number of single symptoms with higher EV titer quartiles (p ¼ 0.004).

Though presence of permanent AF is associated with elevated CRP levels, this elevation is not the result of earlier infections with Chlamydia pneumoniae or Helicobacter pylori or their combination.