The old idea that coronary heart disease is an infectious disease has gained popularity in recent years, and both viral and bacterial pathogens have been proposed to be associated with the inflammatory changes seen in atherosclerosis. Herpes group viruses, notably cytomegalovirus and herpes simplex type 1, have been associated with atherosclerosis and restenosis. Helicobacter pylori and dental infections have also been linked to atherogenesis, but the evidence seems to favor a respiratory, obligatory intracellular bacterium, Chlamydia pneumoniae. The association was originally found in seroepidemiological studies, but the actual presence of the pathogen in atherosclerotic lesions has been repeatedly demonstrated, and during past year the first successful animal experiments and encouraging preliminary intervention studies were published. The causal relationship has not yet been proven, but ongoing large intervention trials and continuing research on pathogenetic mechanisms may lead to the use of antimicrobial agents in the treatment of coronary heart disease in the future.
